CN106456223A

CN106456223A - Tensioning instrument and related bone fixation systems

Info

Publication number: CN106456223A
Application number: CN201580023522.6A
Authority: CN
Inventors: U.许利格
Original assignee: DePuy Synthes Products Inc
Current assignee: DePuy Synthes Products Inc
Priority date: 2014-04-30
Filing date: 2015-04-23
Publication date: 2017-02-22
Anticipated expiration: 2035-04-23
Also published as: WO2015167920A1; JP6657117B2; CA2947276A1; US20150313656A1; CN106456223B; BR112016025231A2; JP2017516528A; EP3137003A1; AU2015253568A1; EP3137003B1; US10052143B2; AU2015253568B2; WO2015167920A4

Abstract

An instrument includes a bearing member, and an actuator spaced from the bearing member in a proximal direction. The instrument includes, or can be attached to, an elongate member that extends from a location of the actuator toward the bearing member. The elongate member can attach to or extend from a portion of an implant, wherein the location is spaced from the bearing member a distance in the proximal direction. The actuator includes a flexible portion that is spaced from the elongate member in a direction perpendicular to the proximal direction, such that, when a force is applied to the flexible portion of the actuator, the flexible portion of the actuator deforms so as to increase the distance between the location and the bearing member.

Description

Tensioning apparatus and related bone fixed system

Cross-Reference to Related Applications

This application claims priority and the rights and interests of the U.S. Provisional Application 61/986,434 submitted on April 30th, 2014, should During the entire disclosure of application is incorporated by reference herein.

Technical field

It relates to tensioning apparatus and related bone fixed system and method.

Background technology

Bone fragments is generally maintained appropriate location to cause bone to heal after osteotomy or reset routine by bone fixation system Close.Bone fixation system includes implant, bone fixation member and apparatus.Implant is generally positioned by this apparatus relative to bone.One In the case of Xie, implant can be manipulated in appropriate location by apparatus, in order to realizes the phase of anatomical structure after cutting or fracture Hope and recover.For example, bone fixation member such as cable strap can be wrapped in around bone segment.It is applied to the tension tautness joint of cable strap Section cable strap around, thus obtain required reset.And for example, it after opening cranium art, is positioned at the inner panel of encephalic next-door neighbour's bone flap With the outside plate being positioned at outside cranium, bone flap is held in place by.The wire of attachment inner panel is tensioned, thus causes outside plate and interior Bone flap is clamped to cranium by plate.

Content of the invention

The embodiment of the disclosure includes apparatus.Apparatus includes supporting member and is spaced apart with supporting member along proximal direction Actuator.Apparatus also includes the retainer being positioned against supporting member extension from actuator.Retainer is configured to attachment To a part for implant, wherein position is spaced a distance with supporting member along proximal direction.Actuator includes along vertically In the flexible portion that the direction of proximal direction is spaced apart with retainer so that when power is applied to actuator, actuator deforms So as the distance increasing between position and supporting member.

The method that another embodiment of the disclosure includes applying tension force to element.Method include by supporting member against The step that the Part I of element is placed.Method includes the Part II of element is connected to retainer, and this retainer is from along closely Side extends to the position of the actuator being spaced apart with supporting member, and wherein actuator has along the direction being perpendicular to proximal direction The part separating with interelement.Method can include the part that actuating power is applied to actuator, thus causes actuator to deform simultaneously And make the position of actuator and retainer move along proximal direction relative to supporting member, thus pulling force is applied to the of element Two parts.

Another embodiment of the disclosure includes apparatus.Apparatus includes supporting member and along proximal direction and supporting member The actuator being spaced apart.Actuator limits the position of the connection element being configured to supporting implant, the wherein position of actuator Spaced a distance with supporting member along proximal direction.Actuator include along be perpendicular to the first direction of proximal direction relative to The flexible portion of the position bias of actuator so that when power is applied to actuator, actuator increases position and supporting member Between distance.Connection element could attach to implant or integral with implant.

Another embodiment of the disclosure is the method for securing an implant to bone, and the method includes to support structure Part is against the step of the Part I placement of implant, and the Part I of implant is configured to the first surface towards bone, plants Enter thing include being configured to towards bone with first surface back to the Part II of second surface, and from the of implant Two connection elements extending partially across Part I.Method can include connection element along between proximal direction and supporting member The position separating is attached to actuator so that the flexible portion of actuator is along direction and the connection element being perpendicular to proximal direction It is spaced apart.Method can include the flexible portion that actuating power is applied to actuator, thus causes actuator that connection element is relative Move along proximal direction in supporting member, thus force the Part I of the Part II of implant towards implant.

The embodiment of the disclosure includes bone fixation system.Bone fixation system includes implant, and this implant includes supporting By bone first surface positioning the first jig main body, and can against bone with first surface back to second surface position The second jig main body.Bone fixation system includes apparatus, and this apparatus has the supporting structure being configured to adjacent second jig main body Part, and it is configured to be coupled to the actuator of the first jig main body so that slender member extends to edge from the first jig main body The position of the proximal direction actuator spaced a distance with supporting member.When actuator is connected to the first jig main body, The flexible portion of actuator is spaced apart along the direction being perpendicular to proximal direction with slender member so that when power is applied to flexible part Timesharing, the flexible portion deformation of actuator is so that the distance increasing between position and supporting member.

Brief description

When reading in conjunction with the accompanying, better understood when the tensioning apparatus of foregoing summary and following the application Detailed description with the exemplary of related bone fixed system.It will be appreciated, however, that the application is not limited to shown The accurate schematic diagram going out and arrangement.In the accompanying drawings：

The plane of the apparatus for the embodiment according to the disclosure for the Figure 1A, illustrates the apparatus being in the first configuration, this device Tool is maintained at bone fixation member around bottom bone；

Figure 1B is the plane of the apparatus being shown in Figure 1A, illustrates the apparatus being in the second configuration, and wherein bone fixes structure Part is tightened around bottom bone, and

Fig. 2 A is the side view of the bone fixation member including main body and locking component；

2B is illustrated in a part of detailed section view of the bone fixation member in Fig. 2 A, shows main body, and this main body passes through Locking component inserts to fix bone fixation member around bottom bone；

Fig. 3 is the perspective view of the multiple bone fixation members being shown in Fig. 2 A, illustrates the bone fixation member tightened around target bone；

Fig. 4 A is the plane of the apparatus being shown in Figure 1A and Figure 1B；

Fig. 4 B is a part of detailed view of the apparatus being shown in Fig. 4 A；

Fig. 4 C and Fig. 4 D is that the apparatus being shown in Fig. 4 A is respectively at the first configuration and the plane of the second actuated.

Fig. 5 A to Fig. 5 C is the perspective view being shown in the apparatus in Figure 1A, Figure 1B and Fig. 4 A to Fig. 4 D；

Fig. 6 A and Fig. 6 B is the partial plan layout being shown in the apparatus in Figure 1A, Figure 1B and Fig. 4 A to Fig. 4 D, illustrates and is configured Become a part of locked component of capture bone fixation member；

The plane of the apparatus for another embodiment according to the disclosure for Fig. 7 A；

The cross section view of the apparatus for intercepting along the line 7B-7B in Fig. 7 A for Fig. 7 B；

A part of sectional view of the apparatus for another embodiment according to the disclosure for Fig. 8 A；

Fig. 8 B is the end-view being shown in the apparatus in Fig. 8 A, illustrates the cross section of bone fixation member；

A part of sectional view of the apparatus for another embodiment according to the disclosure for Fig. 9 A, illustrates and bone is fixed structure Part is maintained at the apparatus around bottom bone；

Fig. 9 B is the end-view being shown in the apparatus in Fig. 9 A, illustrates that a part for bone fixation member and bottom bone are moved Remove；

Figure 10 A to Figure 10 F illustrates and is shown in the embodiment of the cutting blade that the apparatus in Fig. 8 A and Fig. 8 B is used together；

A part of sectional view of the apparatus for another embodiment according to the disclosure for the Figure 11；

A part of sectional view of the apparatus for another embodiment according to the disclosure for Figure 12 A, illustrates and fixes bone Component is maintained at the apparatus of locked configuration；

Figure 12 B is the sectional view being shown in the apparatus in Figure 12 A, illustrates the device that bone fixation member is maintained at unlocked configuration Tool；

A part of sectional view of the apparatus for another embodiment according to the disclosure for the Figure 13；

A part of sectional view of the apparatus for another embodiment according to the disclosure for the Figure 14；

A part of sectional view of the apparatus for another embodiment according to the disclosure for the Figure 15；

A part of sectional view of the apparatus for another embodiment according to the disclosure for Figure 16 A；

Figure 16 B is a part of schematic plan of the apparatus being shown in Figure 16 A；

The local horizontal sectional view of the apparatus for another embodiment according to the disclosure for the Figure 17；

The plane of the apparatus for another embodiment according to the disclosure for Figure 18 A；

A part of plane of the apparatus for another embodiment according to the disclosure for Figure 18 B；

The plane of the bone fixation system for another embodiment according to the disclosure for the Figure 19, illustrates bone implant and bone Cross section；

Figure 20 is the level-of-detail sectional view of the bone fixation system being shown in Figure 19；

Figure 21 is a part of detailed side view of the bone fixation system being shown in Figure 19.

Figure 22 is the detailed end view of the bone fixation system being shown in Figure 19.

Figure 23 is the side view of the bone fixation system according to the embodiment of the disclosure, illustrates the transversal of bone implant and bone Face；

Figure 24 is a part of detailed side view of the bone fixation system being shown in Figure 23；And

Figure 25 is the top view of the bone fixation system being shown in Figure 23, illustrates a part for the apparatus being removed.

Detailed description of the invention

Some term used in description below is only for for the sake of convenience and and nonrestrictive.Vocabulary " right ", " left ", D score and " on " specify the direction in accompanying drawing, in this, as reference.Described vocabulary "front", "rear", " on ", D score and related Optimum position and orientation in human body specified in vocabulary and/or phrase, in this, as with reference to and its be not restricted.Separately Outward, description relates to bone fixation system and associated components and apparatus and/or its part, and they include " proximal end " and " distally End ".Therefore, " proximal direction " or " proximally " refers to the direction of generally distally proximally facing end, end orientation." distally Direction " or " towards distally " refer to the direction that generally proximally end is orientated towards distal end.The bone fixation system of the disclosure Parts are also described herein as " L " and lateral " A " in a longitudinal direction, and prolong laterally along horizontal direction " T " Stretch.Unless otherwise indicated herein, otherwise term " longitudinally ", " laterally " and " laterally " is used for describing each bone fixation system parts Parts with the vertical orientation of component axes.

It relates to bone fixation system, this system includes that the part being configured to implant applies the tensioning of pulling force Apparatus, bone fixation member 24 such as shown in FIG. 1A and 1B, or bone fixation implant 210 He as shown in Figure 19-Figure 25 310.Tensioning apparatus is configured so that when apparatus is connected to implant, and a part for apparatus can shift to apply to implant Pulling force is to secure an implant to bone, as will be described in detail further below.As used herein, implant includes that bone is solid Determine component, clamping device, hone lamella, anchor log, or be configured for being implanted to any other device in the patient.

Forwarding Figure 1A and Figure 1B to, bone fixation system 20 includes apparatus 22 and at least one implant 24, such as multiple implantation Thing 24.Implant 24 be configured to by target bone 28 (such as breastbone) at osteotomy site 30s separate the first bone segment 26a and Second bone segment 26b is fixed together in compression approximated position.Apparatus 22 can include actuator 82 and from actuator 82 along The supporting member 84 that longitudinal direction L extends.Slender member (such as retainer 86) can along the longitudinal direction L from one of actuator 82 Divide and extend towards supporting member 84.Actuator 82 can include the flexible portion 89 being spaced apart with retainer 86 so that when hanging down in power edge Straight when the direction of longitudinal direction L is applied to actuator 82 towards retainer 86, at least a portion of actuator 82 is along longitudinal direction Direction L shifts, so that retainer 86 shifts relative to supporting member 84.When retainer 86 is attached to implant 24, keep The displacement of device 86 applies power to implant 24.According to shown embodiment, apparatus 22 can have the first configuration or initial structure Type (Figure 1A), wherein implant 24 is received by apparatus 22 and around bone segment 26a and 26b；And second configuration or activate structure Type (Figure 1B), wherein retainer 86 has been shifted such that required pulling force is applied to implant 24 and implant 24 around bone Sections 26a and 26b tightens to reduce the size of osteotomy site 30.According to shown embodiment, implant 24 can be solid for bone Determine component, such as cable strap.

Seeing Fig. 2 A-Fig. 3, each bone fixation member 24 can include flexible member, such as band 32, and this band limits band main body 33 And along the length with 32 there is first end 34a and the second end 34b relative with first end 34a, from first end 34a The needle tip 36 extending and the locking mechanism 38 extending from the second end 34b.Band 32 as required can be by any suitable life Thing compatibility material is made, for example PEEK.

Each bone fixation member 24 may also include the first prime area 40 and the second ' locked ' zone 42, this first prime area Along with 32 length a part (for example, with 32 length about 1/3) from first end 34a towards the second end 34b Extending, this second ' locked ' zone extends between the first prime area 40 and the second end 34b.According to shown embodiment party Case, the second ' locked ' zone 42 extends to the second end 34b from the first prime area 40.The second end 34b can limit stayed surface. Supporting member 84 can adjoin stayed surface.First prime area 40 can include multiple little protuberance, the plurality of little protuberance from Band main body 33 is stretched out, and replaces with the recessed area being arranged between adjacent protuberance.Alternatively, initially Region 40 can be substantially smooth and without protuberance or tooth.Second ' locked ' zone 42 can include multiple locking teeth 48, described many Individual locking teeth is from the distance stretched out with main body 33 more than protuberance, and by the recessed area being arranged between adjacent locking teeth 51 separate.It should be appreciated that ' locked ' zone 42 can extend to carry the whole of main body 33 along any part as required.

Locking mechanism 38 includes that shell 50 and band receive slit 52, and this band receives slit and extends through shell 50 and joined It is set to receive the first end 34a with 32.According to shown embodiment, first end 34a is inserted through slit 52 to limit The collar 55 that the fixed side along locking mechanism 38 is arranged.The collar 55 surrounds target bone 28.Locking mechanism 38 is configured to permit band 32 along arrow A direction pass through slit 52 uniaxially translate, in order to reduce the collar 55 around target bone 28 first segment 26a and The size of the second sections 26b.For example, needle tip 36 may pass through slit 52 insert and subsequently for example pass through cutting belt main body 33 neck Portion 56 and remove, this band main body limits the thickness reducing in the position of neighbouring needle tip 36 so that band 32 is maintained at slit 52 In.According to shown embodiment, locking mechanism 38 includes that locking component is such as connected to the tongue 54 of shell 50, and Including at least one complementary teeth, for example, extend to the multiple locking teeths 58 in slit 52.Locking teeth 58 limits beveled leading edge 60, should Beveled leading edge is configured to the complementary bevel leading edge when translating along the direction of arrow A through slit 52 at locking teeth 48 with 32 Cam driven is used on 49.Locking teeth 58 and 48 limits trailing edge 62 and 47 further, and the gradient of this trailing edge is less than beveled leading edge 60 so that trailing edge 62 engages with 47 to prevent from translating along the direction relative with arrow A through slit 52 with 32, and increase is overlapped by this The size of ring 55.

It at intra-operative, is wound around around first segment 26a and the second sections 26b of target bone 28 with 32, and needle tip 36 It is inserted through slit 52 and is drawn across slit 52, in order to making band 32 translate then across slit 52.Needle tip 36 can be by carrying 32 remove, and then also for example manually band 32 can be drawn through slit 52.When band 32 passes through locking mechanism in the direction of arrow A During 38 translation, the little protuberance of prime area 40 can be slid through slit 52 and the locking teeth 58 of not engaging locking mechanisms 38.When When ' locked ' zone 42 with 32 translates across slit 52 along the direction of arrow A, locking teeth 48 and 58 is engageable to prevent from carrying 32 In the tension force that causes make band 32 exit back along the direction relative with arrow A from slit 52.For example, at band 32 along arrow A Direction when translating across locking mechanism 38, reduce around the size of the collar 55 of target bone 28, until causing institute in band 32 Need tension force.

Referring now to Fig. 4 A-Fig. 4 D, tensioning apparatus 22 includes implement body 64, and this implement body limits leading section or distally End 66, the opposed rear end portion that L is spaced apart with leading section 66 along the longitudinal direction or proximal end 68, and along perpendicular In opposite side 70a, 70b that the lateral A of longitudinal direction L is spaced apart.Distal end 66 can limit supporting member 84 so that causes Dynamic device 82 proximally end 68 extends to supporting member 84.According to shown embodiment, main body 64 L along the longitudinal direction is thin Long limiting length, there is the width of the thickness extending along horizontal direction T and laterally direction A extension.It should be appreciated that Longitudinal direction L can be described as first direction, and lateral A can be described as second direction.Or, longitudinal direction L can be described as second party To, and lateral A can be described as first direction.Implement body 64 can be made up of any material being applicable to medical application.Material Can be metal material, such as stainless steel, titanium, titanium-base alloy, polymeric material (such as such as PEEK), or metal and polymeric material Combination.

Forwarding Figure 1A, Fig. 4 C and Fig. 4 D to, apparatus 22 includes actuator 82 and supporting member 84.In addition, apparatus 22 is configured Become retainer 86 is extended from the selection position 85 of actuator 82.For example, retainer 86 can select to be attached at 85s, position Actuator 82, or integral with actuator 82 at selection 85s, position.Position 85 is selected to be spaced apart a spacing with supporting member 84 From.Retainer 86 is configured to mobile relative to supporting member 84 L along the longitudinal direction (for example along proximal direction 7), in order to protecting Apply pulling force along retainer 86 when holder 86 is attached to implant 24.According to shown embodiment, apparatus 22 is configured Becoming to make when laterally direction A is applied to actuator 82 to relative compressive force F1 and F2 (Figure 1A), actuator 82 is towards holding Device 86 deforms.Actuator 82 laterally direction A makes retainer 86 move away from along proximal direction 7 towards the deformation of retainer 86 Bearing member 84, thus increase the distance between position 85 and supporting member 84, as detailed further below.Retainer 86 is along nearside The movement in direction 7 is along proximal direction 7 tractive implant 24.For example, when actuator 82 is in the first configuration (Fig. 4 C), retainer 86 are in primary importance relative to supporting member 84.When actuator 82 is in the second configuration or actuated (Fig. 4 D), keep The supporting member 84 that device 86 has been spaced apart with primary importance relative to L along the longitudinal direction (such as proximal direction 7) is displaced to second Position.

Forwarding Figure 1B to, the Part I (such as locking mechanism 38) that supporting member 84 is configured to against implant 24 is put Put so that the Part II (such as band 32) of implant 24 can be inserted in retainer 86.At retainer 86 along proximal direction 7 When mobile, the Part I of implant 24 can be maintained appropriate location relative to retainer 86 by supporting member 84.According to shown The embodiment going out, when apparatus 22 is positioned such that supporting member 84 abutment surface 34b and retainer 86 are attached to carry 32 When, the actuating of actuator 82 causes the attachment part with 32 to be advanced through locking mechanism 38.As detailed further below, activate The applying of power F1 and F2 causes actuator 82 to deform, so that retainer displacement.Actuator 82 is configured so that power F1 and F2 Applying make actuator 82 be deformed to be enough to overcome the degree with any frictional force between 32 and locking mechanism 38.

Forwarding Fig. 4 B to, supporting member 84 limits a part of receiver 67 being configured to catch-holder 86, and quilt It is configured to pass through a part of passage 95 being connected to retainer 86 wherein receiving implant 24.The supporting structure of implement body 64 Part 84 or distal end 66 limit the opposite wall 92 and 93 that laterally direction A is spaced apart, and extend between wall 92 and 93 Distal walls 94.Wall 92 and 93 extends from actuator 82 towards distal walls 94.Wall the 92nd, 93 and 94 restriction inner surface (unnumbered), This inner surface at least partially defines receiver 67.Receiver 67 has laterally direction A and extends to from the inner surface of wall 92 The thickness R of the inner surface of wall 93.Receiver 97 has portions of proximal 69a and relative to portions of proximal 69a towards distal end 66 Distal part 69b arranging along distal direction 9.Thickness R can be tapered towards distal walls 94 so that the thickness at distal part 69b Degree R is less than the thickness R at portions of proximal 69a.The thickness R of distal part 69b is slightly larger than the distal end 16 of retainer 86 Thickness so that the part of the wall 92 and 93 limiting distal part 69b of receiver 67 provides and the distal end of retainer 86 The frictional fit of 16.When apparatus 22 activates and cuts received bone fixation member 24, retainer 86 and supporting member 84 Between frictional fit improve apparatus stability, as detailed further below.As described above, passage 95 L along the longitudinal direction extends Through distal walls 94.Passage 95 be sized to and it is configured through wherein receiving the band 32 of bone fixation member 24 (Fig. 2 A).Band 32 can extend across passage 95 and can be kept by retainer 86, as detailed further below.

With continued reference to Fig. 4 A and Fig. 4 B, retainer 86 can prolong from the selection position 85 of actuator 82 towards supporting member 84 Stretch.According to shown embodiment, retainer 86 is elongated along retainer axis 12 and includes retainer proximal end Portion 14 and the retainer distal end 16 being spaced apart with retainer proximal end 14 along retainer axis 12.Retainer proximal end Portion 14 can be connected to the implement body 64 relative with supporting member 84 so that retainer 86 is from the proximal end 68 of implement body 64 Extend towards supporting member 84.Or, retainer proximal end 14 can be integral with actuator 82.When apparatus 22 is in the first structure When type or initial configuration, the distal end 16 of retainer 86 can be directed at supporting member 84.But, retainer 86 can be configured to Making when apparatus 22 is in initial configuration, the distal end 16 of retainer 86 is not directed at supporting member 84.Retainer 86 Distal end 16 carries locked component 172a and/or 172b, and this locked component is configured to receive implant 24 and is attached to Implant 24, describes in detail as discussed further below.

Actuator 82 is configured in response to the applying of compression stress F1 and F2 and deforms to make retainer 86 along longitudinal direction Direction L shifts, as described above, actuator 82 includes flexible portion 89.Flexible portion 89 can include the first actuating component 74 and with The second relative actuating component 76 of first actuating component 74.First actuating component 74 and the second actuating component 76 can laterally directions A is spaced apart with retainer 86.According to shown embodiment, the first actuating component 74 and the second actuating component 76 can respectively by It is configured to the first arm and the second arm, be configured to when compression stress F1, F2 are applied to the flexible portion 89 of actuator 82 spy Determine position along the flexure of each actuating component or bending.Before first actuating component 74 includes being disposed adjacent with supporting member 84 End 75a, is arranged on rearward end 75b at the proximal end 68 of apparatus 22, and is arranged on leading section 75a and rearward end 75b Between the first supporting member 78.First actuating component 74 is elongated and extends along the first actuator axis 4 (Fig. 4 C). First actuating component 74 limits the inner surface 88a towards retainer 86, and relative outer surface 88b.Second actuating component 76 Also include the leading section 77a adjacent with supporting member 84, be arranged on rearward end 77b at the proximal end 68 of apparatus 22, and The second supporting member 79 being arranged between leading section 77a and rearward end 77b.Second actuating component 76 be elongated and along Second actuator axis 5 (Fig. 4 C) extends.Second actuating component 76 limits the inner surface 90a towards retainer 86, and relatively Outer surface 90b.

Forwarding Fig. 4 A to, actuator 82 can include at least one joint, such as respectively multiple joint 80a-80d and 81a- 81d.According to shown embodiment, the first actuating component 74 and the second actuating component 76 each limit at least one joint, It is such as respectively multiple joint 80a-80d and 81a-81d.Thus, the first actuating component 74 and the second actuating component 76 can Being referred to as joint and moving actuator, it is configured to carry out when compression stress F1 and F2 are applied to the flexible portion 89 of actuator 82 Joint is moved.First actuating component 74 can include more than first joint 80a, 80b, 80c and 80d.First couple of joint 80a and 80b It is positioned between rearward end 75b and the supporting member 78 of the first actuating component 74, and second couple of joint 80c and 80d is positioned at support Between component 78 and the leading section 75a of the first actuating component 74.First actuating component 74 also include being arranged on first pair of joint and The first supporting member 83a between each joint in second pair of joint and other supporting member 83b.

With continued reference to Fig. 4 A, the second actuating component 76 includes more than second joint 81a, 81b, 81c and 81d, and one Or multiple supporting member 87a, 87b.Joint 81a and 81b be positioned at rearward end 77b of the second actuating component 76 and supporting member 79 it Between.Joint 81c and 81d is positioned between supporting member 79 and the leading section 77a of the second actuating component 76.As it can be seen, first causes Dynamic member knuckle 80a, 80b, 80c, 80d can laterally direction A and second actuating component joint 81a, 81b, 81c and 81d couple Accurate.Second actuating component 76 also includes be arranged between each joint in corresponding first pair of joint and second pair of joint first Supporting member 87a and the second supporting member 87b.Rigid support members 78 and 79 and supporting member 83a, 83b and 87a, 87b (supporting member is sometimes herein with reference to mark " 83 " and " 87 ") is generally more rigid than joint 80a-80b and 81a-81d.Cause This, the supporting member of the first actuating component the 78th, the first supporting member 83a and the second supporting member 83b can be collectively referenced as rigidity Support component.Equally, the supporting member of the second actuating component 76 the 79th, the first supporting member 87a and the second supporting member 87b can be common It is referred to as rigid support members.

Seeing Fig. 4 A, the thickness of the first actuating component 74 and the second actuating component 76 can be along corresponding actuating component axis 4 Change with 5.For example, compared with the thickness of each joint 80a-80d and 81a-81d, supporting member the 78th, 83 and the 79th, 87 can be respective There is different thickness.This difference in thickness can be conducive to making actuator 82 be deformed into actuated.First actuating component 74 and Two actuating component 76 limit support member thickness T1 and T2 at respective support component the 78th, 83a, 83b and the 79th, 87a, 87b.Support Component thickness T1 extends to outer surface 88b along the direction being perpendicular to corresponding first actuating component axis 4 from inner surface 88a.The Two actuating component support member thickness T2 are along being perpendicular to the direction of the second actuating component axis 5 from inner surface 90a extends to Surface 90b.Thickness T1 can change in each supporting member the 78th, 83a and 83b.In addition, thickness T2 can be for each supporting member 79th, 87a and 87b changes.

With continued reference to Fig. 4 A, each joint limits the thickness being typically smaller than support member thickness.For example, activate along first Each joint of component 74 limits the first joint thickness D1 (not shown) being perpendicular to the first actuating component axis 4.Joint thickness The thickness less than supporting member the 78th, the first supporting member 83a and the second supporting member 83b for the D1.Along the second actuating component 76 Each joint 81 limits the second joint thickness D2 being perpendicular to the second actuating component axis 5.Second joint thickness D2 is less than support The thickness of component the 79th, the first supporting member 87a and the second supporting member 87b.It should be appreciated that joint thickness D1, D2 can be for often Individual joint changes along the first actuating component 74 and the second actuating component 76.

Referring now to Fig. 4 C and Fig. 4 D, joint 80a-80d and 81a-81d can be along by support member thickness T1, T2 and pass The corresponding actuating component 74 and 76 that joint changing between thickness D1, D2 is formed limits stress raiser.It is applied to actuator 82 Power F1 and F2 cause the local buckling at stress raiser, this then cause rigid support members the 78th, 83a, 83b, the 79th, 87a, 87b is respectively relative to first group of joint 80a-80d and second group of joint 81a-81d bending.Therefore, it is applied to the first actuating component 74 and second actuating component 76 compression stress F1 and F2 cause bending substantially at 80a-80d and 81a-81b of joint, and activate Other parts (such as rigid support members) of component 74 and 76 stand less bending.Therefore, actuator 82 is suitable to have flexibility And rigidity, this flexibility allows the first actuating component 74 and the second actuating component 76 in response to the load being applied by the hand of user Bending, this rigidity causes retainer 86 to shift relative to supporting member 84.In addition, actuator 82 has elasticity, as power F1 and F2 When actuator 82 discharges, this elasticity causes the first actuating component 74 and the second actuating component 76 to recover its corresponding unchanged morpheme Put.

Actuator 82 is configured to have and is in first shape (Figure 1A and Fig. 4 C) of initial configuration and at actuator 82 The second shape (Figure 1B and Fig. 4 D) being different from the first shape when being in the second actuated.According to shown embodiment party Case, when actuator is in initial configuration, each actuating component 74 and 76 can limit generally trapezoidal shape relative to retainer 86. Additionally, when actuator 82 is in actuated, actuating component 74 and 76 can limit the substantial linear shape with longitudinal direction L alignment Shape (Figure 1B, Fig. 4 D).Apply compression stress F1 to the flexible portion 89 of actuator 82 and F2 causes the first actuating component 74 and second Actuating component 76 bends at each joint 80a-80d, 81a-81d, and rigid support members the 78th, the 83rd, the 79th, the bending of 87 minimum Change.This causes the first actuating component 74 and the second actuating component 76 to deflect into substantial linear shape, as shown in Figure 1B and Fig. 4 D.When Compression stress F1 and F2 are when apparatus 22 removes, and the first actuating component 74 and the second actuating component 76 are recovered or bounce back into have substantially The initial configuration of trapezoidal shape, as shown in Figure 1A and Fig. 4 C.It can thus be stated that the shape of actuator 82 is configured so that foot So that the applying of power of actuator 82 deformation will overcome acts on 1) between bone fixation member 24 and locking mechanism 38 and 2) bone Fixing frictional force between component 24 and bone, thus cause the displacement of retainer 86 and be attached bone admittedly relative to locking mechanism 38 Determine component 24.For example, if user along be transversely to the machine direction the direction of direction L to actuator 82 apply relative power F1 and F2, then the first actuating component 74 and the second actuating component 76 deform, thus cause selecting position 85 to move away from supporting member 84, This causes retainer 86 to make bone fixation member 24 retract away from locking mechanism 38.Be applied to actuator 82 as power F1 and F2 so that When actuator 82 deforms, the actuator 82 of deformation stores the potential energy that be enough to make actuator 82 return its initial configuration.When power F1 and When F2 is released, the potential energy being stored in the actuator 82 of deformation causes actuator 82 to recover its initial configuration.

First actuating component 74 and the second actuating component 76 can have or include any other structure, device or feature knot Structure, or any shape that the gained with the deformation and retainer 86 L in a longitudinal direction that can allow for actuator 82 moves. According to optional embodiment, each joint can be configured to be limited in inner surface 88a, 90a and outer surface 88b, 90b one Individual or two at groove.Such groove can partially or completely extend across actuator axis the 4th, 5.In other optional enforcement In scheme, joint can be configured to hinge.Joint can include rigid support members being allowed relative to adjacent pivotal support structure Any other structure that part pivots or device or feature structure.In addition, the first actuating component 74 and the second actuating component 76 can quilts It is configured without above-mentioned joint.According to such optional embodiment, the first actuating component 74 and the second actuating component 76 can phases For the some (not shown) bending being limited by retainer 86.For example, the first actuating component and the second actuating component are along accordingly Axis of bending can be elongated.Every axis of bending can have a radius of curvature, or has multiple radius of curvature alternatively.Example As bending actuating component can have the axis of bending of semicircular in shape shape.In addition, bending actuating component can have any number of Shape of cross section, circle, linear, square etc..

See Fig. 4 C and Fig. 4 D, apply power F1 to the flexible portion 89 of actuator 82 and F2 causes actuating component 74 and 76 to become Shape, thus cause proximal end 68 L in a longitudinal direction of apparatus 22 to move away from supporting member 84.Result is when actuator 82 Increase distance X selecting between position 85 and supporting member 84 during actuating.According to shown embodiment, at actuator 82 When the first configuration, select position 85 L along the longitudinal direction and supporting member 84 X spaced apart.When actuator 82 is actuated to During the second configuration, actuating component 75 and 76 deform, cause select position 85 move farther away from supporting member 84, thus increase away from From.For example, when actuator 82 is in the first configuration, the position 85 that apparatus 22 can have from actuator 82 extends to supporting member First distance X of 84.When actuator 82 is in the second actuated, the position 85 that apparatus 22 limits from actuator 82 extends to The second distance Y of supporting member 84, this second distance Y are more than the first distance X.Furthermore it is possible to say, when actuator 82 is in first When configuration or initial configuration, as shown in Figure 4 C, apparatus 22 has and distally holds along with the longitudinal axis 8 that longitudinal direction L is directed at Portion 66 extends to the first effective length 2 of proximal end 68.When actuator 82 is in actuated, as shown in Figure 4 D, apparatus 22 have the second effective length 3 extending to proximal end 68 along longitudinal axis 8 distally end 66, this second effective length More than the first effective length 2.Difference between second effective length 3 and the first effective length 2 corresponding to retainer 86 relative to The degree that supporting member 84 moves.In the shown embodiment, when apparatus 22 not yet activated, the distal end portion of retainer 86 Portion 16 and the inner surface E1 spaced apart of distal walls 94.When apparatus 22 activated, the distal end of retainer 86 16 with remote The inner surface E2 spaced apart of sidewall 94.Difference between distance E2 and E1 is to move relative to the retainer 86 of supporting member 84 Position degree.Although shown embodiment illustrates distal end 16 and distal walls 94 E1 spaced apart of retainer 86, but The retainer 86 being in initial configuration can adjoin distal walls 94.In such embodiments, E1 can be at or close to zero (0).

Referring now to Fig. 5 A-Fig. 5 C, when retainer 86 is attached to implant 24, apparatus 22 can include being configured to cutting At least one cutting assembly 120 of implant 24.Cutting assembly 120 can include being supported by supporting member 84 and being configured to cut Cut one or more blades of implant 24.Supporting member 84 is configured to carry at least one blade 101, such as a pair blade 101 and 102.First blade 101 extends from the first wall 92 towards passage 95, and the second blade 102 is from the second wall 93 towards passage 95 extend and are spaced apart with the first blade 101.First blade 101 and the second blade 102 are positioned within device 86 to limit The gap 106 extending between blade 101 and 102.Gap 106 has the gap size that laterally direction A extends.Passage 95 Can have the channel size corresponding to gap size that laterally direction A extends.In other embodiments, gap size can It is slightly lower than channel size or be more than channel size.Supporting member 84 can include blade 101 and 102 is maintained at supporting member 84 On appropriate location in coupling 108.In the embodiment being shown in Fig. 5 A-Fig. 5 C, coupling 108 includes that size is set Become to receive groove 110a and 110b of respective blade 101 and 102, and be spaced apart towards passage 95 with groove 110a and 110b At least one protuberance 112.One end of blade 101 and 102 is maintained in groove 110a and 110b and blade 101 He The opposed end against protuberance 112 of 102.With 32, there is the width W that T extends in transverse direction so that bandwidth W is less than Gap size.Because bandwidth is less than gap size, so apparatus 22 causes cutter along direction of rotation 13 around the rotation of axis 8 It in the received band 32 of piece 101 and 102 incision, and is applied to the torsion shear band 32 with 32.

Seeing Fig. 6 A-Fig. 6 B, apparatus 22 can include that the part being configured to implant 24 is fixed to retainer 86 One or more locked components.As it can be seen, the distal end 16 of retainer 86 supports the first locked component 172a and second lock Determine assembly 172b.Locked component 172a and 172b is essentially similar.Therefore, the first locked component 172a hereafter will only be described. According to shown embodiment, locked component 172a includes being configured to be fixed to the locking component of retainer 86 with 32 174a.When carrying 32 to be fixed to retainer 86, the movement of retainer 86 L in a longitudinal direction can be along band 32 applying tension force.Lock Determine component 174a to include locking main body and the 176th, extend through the slit 177 of locking main body 176, and at least one complementary teeth, all As extended to the multiple locking teeth 178a in slit 177.Locking main body 176 include being connected to retainer 86 leg 179a and 179b.In addition, locking main body 176 limits first surface 180 and opposite second surface 181.Second surface 181 can limit tooth 178a.First surface 180 and second surface 181 can at least partially define slit 177.In alternative embodiments, leg 179a and 179b can be for flexible to allow the iteration of locking component 174a to change between one or more positions or partially Pressure.

Retainer 86 can support the first locked component 172a along the first orientation and take along relative with the first orientation second To supporting the second locked component 172b.Therefore, apparatus 22 could attach to the band 32 of implant 24, but regardless of apparatus 22 is relative to band The mode of 32 orientations.For example, the first locked component 172a is arranged in retainer 86 so that tooth 178a is approximately towards wall 92 and prolongs Stretch.Second locked component 172b is arranged in retainer 86 so that tooth 178b is approximately towards wall 93 and arranges.Thus, tooth is worked as 178a (or 178b) can be the first orientation when extending towards wall 92, and the second orientation is relative with the first orientation so that tooth 178a (or 178b) extends towards wall 93.

According to optional embodiment, apparatus 22 can be configured to selectively propel implant 24 along proximal direction 7. For example, retainer 86 passage 95 is configured to receive a part for implant 24.Retainer 86 includes inner surface, such as locking group The surface of part 172a and 172b, its be configured to be selectively engaged and be disengaged implant 24 by receiving portion.Activate Device 82 is operable to so that retainer 86 moves to from first from primary importance along proximal direction relative to supporting member 84 Put the second place of displacement, and make retainer 86 return from the second place along the distal direction contrary with first direction subsequently To primary importance.Retainer 86 be configured to when retainer 86 moves along proximal direction engage implant 24 by acceptance division Point, and be disengaged when retainer moves along distal direction implant 24 by receiving portion.Retainer and implant Being engaged and disengaged between part is repeatable to advance implant 24 to further pass through the passage 95 of retainer.

Forwarding Fig. 7 A and Fig. 7 B to, apparatus 422 can be configured to be similar to above-mentioned apparatus 22.Apparatus 422 can include actuator 482nd, supporting member 484 and retainer 486.Use is used for what both apparatuses 22 and 422 had by the hereafter description to apparatus 422 The same reference numerals of element.Supporting member 484 in apparatus 422 and retainer 486 are similar to the supporting member 84 of apparatus 422 With retainer 86.Therefore, supporting member 484 can limit the receiver being similar to above-mentioned receiver 67.The size of receiver is set Surely the distal end 416 of catch-holder 486 and the friction between confining wall 93 and 94 and retainer distal end 416 is become to join Close.Additionally, supporting member 484 carries cutting assembly 120.In addition, apparatus 442 can include similarly as described above and be shown in figure The locked component 442 of the locked component 172 in 6A-Fig. 6 B.For example, locked component 442 be similar to above-mentioned locked component 172a and 172b configures.Therefore, locked component 442 can include locking component 174, and this locking component includes that the 176th, locking main body extends through The slit 177 of locking main body 176, and extend to the locking teeth 178 in slit 177.

With continued reference to Fig. 7 A and Fig. 7 B, actuator 482 can be curved body 464, and this curved body is configured to keep Device 486 is actuated into second place (not shown) along proximal direction 7 from primary importance as shown in Figure 7 A.Curved body 464 or Actuator 482 can include the first bending actuating component 474 and the second actuating component 476.First or bending actuating component 474 at device Between tool proximal end 68 and supporting member 484 along axis of bending 404 be elongated.First actuating component 474 includes relatively In axis 404 outward extending side extension 478a and 468b to limit handrail.Second actuating component 476 is along axis of bending 505 is elongated.Second actuating component 476 includes gripping hole 450a, 450b and 450c.Grip hole 450a, 450b and 450c It is sized to receive the finger of user.User can grip actuator 482 so that the palm of user is adjacent to extension The finger of 478a and 478b and user may extend in the 450a-450c of hole.Bend actuator 482 is configured so that works as device When tool 422 is in the first configuration or initial configuration, it is sufficient to the power making flexible portion deform be enough to overcome and acts on bone fixation member Frictional force between 24 and locking mechanism 38 so that bone fixation member 24 is pushed into the distance that be enough to reduce osteotomy site 30.Edge The direction being transversely to the machine direction direction L and apply power F1 to bend actuator 482 and F2 causes the first bending actuating component 474 and Two bending actuating component 476 are deformed into more linear shape, and this causes when implant 24 is attached to retainer 486, keeps Device 486 is retracted along proximal direction 7.When applying power F1 and F2 are so that apparatus 422 deforms, during so that actuator 482 deforms, deformation Actuator 482 store and be enough to the potential energy that makes actuator 482 return to initial configuration.When power F1 and F2 remove from apparatus 422, Actuator 482 returns to its initial configuration.

Forward Fig. 8 A and Fig. 8 B to, the apparatus 472 of another embodiment according to the disclosure is shown.Apparatus 472 is constructed Become to be substantially similar to apparatus 22 that is mentioned above and that be shown in Figure 1A-Fig. 6 C.Unless otherwise noted, otherwise apparatus 22 He Element total between 472 has identical reference numerals.According to optional embodiment, apparatus 472 includes from actuator 82 (not Illustrate) supporting member 494 that extends.Supporting member 494 can include upper wall 492 and cutting assembly 150, and this cutting assembly is by upper wall 492 support and are configured to cut implant 24.Cutting assembly 150 includes at least one blade being supported by actuator 156 122.Actuator 156 be configured to by blade 122 along with lateral A alignment or relative to lateral A bias direction G Mobile.Blade cuts implantation along the retaining portion from locking mechanism 38 (not shown) cuts off with 32 that is moved through of direction G Thing 24.Actuator 156 can be the lever 158 being connected to supporting member 494.That supporting member 494 and lever 158 can be integrated or Single parts.Lever 158 includes the base portion 157 being connected to the wall 92 of supporting member 494, and receives and be attached to blade 122 and towards with 32 extend supporting members 159.Lever 158 is configured to by blade 122 laterally direction A bias far From band 32.Power F3 is applied to lever 158 makes lever 158 bias towards supporting member 494, and this causes blade 122 to cut then Band 32.In other embodiments, cutting assembly 150 can include being positioned at the wall relative with the wall 492 of supporting member 484 ( Not shown in Fig. 8 A and Fig. 8 B) on other actuator.

Forwarding Fig. 9 A and Fig. 9 B to, according to another embodiment of the disclosure, another apparatus 502 includes supporting member 504 and be configured to cut implant 24 cutting assembly 120.Apparatus 502 is similar to apparatus 22 and similar reference number For the total element of apparatus 22 and 502.According to shown embodiment, supporting member 504 includes the first wall or upper wall 506th, the second wall or lower wall 508, and the 3rd wall or distal walls 510.Supporting member 504 also includes along axis 8 distally wall 510 prominent coupling members 128.Apparatus 502 also includes cutting assembly 120, and this cutting assembly includes at least one blade, such as A pair blade 122 and 124 being supported by blade actuator 126.Blade actuator 126 is rotationally coupled to coupler members 128 so that blade actuator is rotatable relative to supporting member 504.Blade actuator 126 is relative to carrying 32 positioning blades 122 With 124.Blade actuator 126 is configured to rotate relative to the supporting member 504 of apparatus 22.Blade actuator 126 includes edge The main body 130 that axis 8 extends.Main body 130 limits the bore hole 132 extending along axis 8.Main body 130 limits interior table further Face 134 and along the opposing outer face 136 being perpendicular to the direction of axis 8 and inner surface 134 is spaced apart.Inner surface 134 limits Bore hole 132.Inner surface 134 is further defined by engagement member 138, such as depressed part.Main body 130 is further defined by towards distal surface 139, should Surface is configured to carry blade 122 and 124.According to an embodiment, limit pair of notches (not towards distal surface 139 Numbering), this otch receives blade 122 and 124 and hold it on actuator 126.Coupling 128 can include along distally Direction 9 extends to the protuberance 140 bore hole 132 from supporting member 504, and is connected to the joint structure of blade actuator 126 Part 142.Protuberance 140 be sized to coordinate in bore hole 132 so that blade actuator 126 can be relative to protuberance 140 rotate around axis 8 along direction of rotation 13.Engagement member 142 coordinates the joint of the complementary shape in blade actuator 126 In component 138.Engagement member 138 and 142 is configured to protect blade actuator 126 in a longitudinal direction on protuberance 140 Hold in position, also allow for blade actuator 126 and rotate along direction of rotation 13 around protuberance 130.Therefore, engagement member 138 can be, for the ring-shaped groove and the engagement member 142 that are limited by main body 130, the ridge extending around the girth of protuberance 140. It should be appreciated that engagement member 138 can be ridge, and engagement member 142 can be groove or depressed part.Blade 122 and 124 be spaced apart with It is limited between blade 122 and 124 gap blade distance B1 that laterally direction A extends.Band 32 has width W, this width W edge Horizontal direction T extends so that bandwidth W is less than gap blade distance B.Rotate along direction of rotation 13 in blade actuator 126 When, blade 122 and 124 is cut in band, thus cuts off the retaining portion with 32 from locking mechanism 38.

Forwarding Figure 10 A-Figure 10 F to, one or more blade configuration can be used together with any one in above-mentioned cutting assembly. According to shown embodiment, blade 100 can include vane body 103 and angularly offset relative to axis 109 To cutting edge 104a and 104b.Cutting edge 104a and 104b intersects to limit insert tip 105.In addition, vane body 103 can have The shape of cross section of promising V-arrangement.In other embodiments being shown in Figure 10 C and Figure 10 D, cutting edge 104 is bending.Separately Outward, vane body 103 can have the shape of cross section for U-shaped.Additionally, blade 100 can have relative to blade axis 109 angulation The cutting edge 104 of degree skew.Vane body 103 can have the shape of cross section of substantial linear.Although illustrating some blade configuration, but It should be appreciated that any blade configuration all can be used together with apparatus 22.

Turning now to Figure 11, the apparatus 522 of another embodiment according to the disclosure includes supporting member 526 and stablizes Assembly 160, this stable assembly is configured to apparatus 522 is connected to locking mechanism 38, also allows for apparatus 552 relative to stable group Part 160 and locking mechanism 38 rotate, in order to the retaining portion of cutting belt 32.Apparatus 522 is configured to be substantially similar to above Apparatus 22 that is described and that be shown in Figure 1A-Fig. 6 B.Therefore, apparatus 22 will use similar reference mark with 522 total elements Number.According to optional embodiment, supporting member includes opposite wall 524 and 525, and distal walls 527.Stablize assembly 160 to wrap Including main body 162, this main body limits the leading section rearward end 161 that the 164th, L is spaced apart in a longitudinal direction with leading section 164, and L extends through bore hole 166 therein in a longitudinal direction.Main body 162 be limited to further leading section 164 and rearward end 161 it Between extend inner surface 168.Inner surface 168 limits bore hole 166.Bore hole 166 includes front portion or implant receiver part 170a With rear portion or apparatus receiver part 170b.Implant receiver part 170a be sized to and its be configured to The outer surface of the locking mechanism 38 of implant 24 coordinates.Rear portion 170b be sized to and its be configured to receive supporting Component 84.Main body 162 includes leg 163a and 163b partly limiting the rear portion 170b of bore hole 166.Leg 163a and 163b includes Corresponding first engagement member 165a and 165b.Wall 524 and 525 limits and is configured to coordinate with the first engagement member 165a and 165b The second engagement member 167a and 167b.According to shown embodiment, the first engagement member 165a and 165b is protuberance, And depressed part or groove that the second engagement member 167a and 167b is complementary shape.It should be appreciated that engagement member 165a and 165b Can be depressed part, and engagement member 167a and 167b can be groove.When stable assembly 160 is connected to locking mechanism 38 and apparatus Supporting member 84 when receiving in bone parts 170b, apparatus 522 can be around axis 8 relative to stable assembly 160 and locking machine Structure 38 rotates.In the optional embodiment of apparatus 522, engagement member 165a and 165b can be circumferentially extending around axis 8.At this In the embodiment of sample, the distal end 66 of apparatus 522, such as supporting member 526, can have and conform to the similar of bore hole 166 The circular cross sectional shape of shape.In addition, engagement member 167a and 176b can around supporting member 526 circumferentially extending with Circumferentially disposed engagement member 165a and 165b engages.

In alternative embodiments, apparatus 522 optionally departs from from stable assembly 160 so that apparatus 522 can phase Stable assembly 160 and locking mechanism 38 are rotated.In such embodiments, leg 163a and 163b is spaced apart and limits The gap extending between the two.Supporting member 84 is connected to stable assembly 160, as mentioned above.It according to optional embodiment, is Rotation apparatus 522, supporting member 84 can be engaged with leg 163a, 163b by supporting member 84 biased disengaging and from stable group Part 160 is disengaged.For example, leg 163a, 163b can when supporting member 84 is along proximal direction 7 tractive flex outward, therefore connect Close component 165 and 167 to be disengaged.When supporting member 84 departs from, apparatus 522 can select as required and turn with cutting belt 32.

As illustrated in figs. 12 a and 12b, another embodiment of apparatus 562 includes the locking group being carried by retainer 586 Part 572.Apparatus 562 is similar to above-mentioned apparatus 22, and therefore use is hereafter used for apparatus 22 and apparatus to the description of apparatus 562 The same reference numerals of element (such as actuator the 82nd, supporting member 84 and cutting assembly 120) total between 562.According to can The embodiment of choosing, retainer 586 carries locked component 572 and locked component 572 is configured at lock as illustrated in fig. 12 Determining to change between configuration and unlocked configuration as shown in Figure 12 B, the band 32 inserting in locked configuration is fixed to retainer 586, In unlocked configuration, locked component 572 is not attached to carry 32 so that band 32 is allowed to along retainer 586 along distal direction 9 flat Move.

With continued reference to Figure 12 A and Figure 12 B, according to shown embodiment, locked component 572 includes locking component 574. Locking component 574 includes locking main body 576 and at least one tooth, such as multiple locking teeths 578.Locking main body 576 includes coupling Leg 579a and 579b to retainer 586.Leg 579a and 579b is flexible, in order to allow locking component 574 in locked configuration And change between unlocked configuration.In addition, locked component 572 can include the surface 581 relative with tooth 578.Surface 581 does not has Tooth.The distal end 516 of retainer 586 limits at least one room 19 being sized to keep locking component 574.Retainer 586 can limit the retainer inner surface including opposing surface portions 17a and 17b.Retainer inner surface can at least partially define Room 19.Retainer inner surface 17a and 17b can be described as inner surface 17.Between leg 579a and 579b and respective surfaces part 17a and 17b Separate to provide space to move between locked configuration and unlocked configuration for locking main body 576.When band 32 passes through passage 95 When being inserted in retainer 586, band 32 translates along proximal direction 7 above locking component 174 so that band tooth 48 engages locking Component tooth 578.Translation further with 32 causes leg 579a and 579b to bend, thus locking component 574 is biased into unblock structure Type (Figure 12 B) so that band 32 can translate further along proximal direction 7.When apparatus 522 is actuated such that retainer 586 shifts simultaneously And when therefore retracting away from the locking mechanism 38 of bone fixation member 24 along proximal direction 7, locking component 574 is biased into locked configuration (Figure 12 A), wherein the 48th, tooth 578 engages to prevent from carrying 32 to translate along distal direction 9.

In embodiment in being shown in Figure 13, the apparatus 622 of another embodiment according to the disclosure includes supporting Component the 84th, retainer 686, and locked component 672a and 672b that retainer 686 is carried.Apparatus 622 is similar to above-mentioned device Tool 22 and 562.Locked component 672a is substantially similar to locked component 672b, and therefore locked component hereinafter will be only discussed 624a.Locked component 672a includes locking component 674a.Locking component 674a includes locking main body 676a and at least one complementation Tooth, such as multiple locking teeth 678a.Locking main body 676a includes leg 679a and 679b being connected to retainer 686.In use, First locked component 672a is arranged in retainer 686 so that tooth 678a is approximately towards the tooth 678b of the second locked component 672b Extend.Thus, the first locked component 672a can be supported along the first orientation by retainer 686, and the second locked component 672b is supported along second orientation relative with the first orientation by retainer 686, is similar to above-mentioned locked component 172a and 172b.? During use, apparatus 622 could attach to the band 32 of implant 24, but regardless of apparatus 622 is relative to the mode with 32 orientations.Keep The distal end 616 of device 686 limits at least one room, is such as sized to receive a pair of locked component 672a and 672b Room 619a and 619b.Retainer 686 can limit retainer inner surface 617a and 617b, and it at least partially defines respective compartments 619a And 619b.

Forwarding Figure 14 to, the apparatus 722 of another embodiment according to the disclosure includes carried by retainer 786 first Locked component and the second locked component.Apparatus 722 is similar to above-mentioned apparatus 22, and therefore hereafter the description to apparatus 722 will use Identical for element (such as actuator the 82nd, supporting member 84 and cutting assembly 120) total between apparatus 22 and apparatus 722 Reference number.

With continued reference to Figure 14, apparatus 722 can include locked component, and this locked component can be configured to the first locking plug-in unit 182 and second lock plug-in unit 183.Plug-in unit 182 and 183 is similarly configured, and therefore hereinafter will only describe one insert Part 183.Plug-in unit 183 includes locking main body the 776th, tooth 778 and flexible leg 779a and 779b.Leg 779a and 779b is connected to keep Device 786.Retainer 786 can include upper chambers 719a and relative bottom compartment 719b, and it keeps the first locking plug-in unit 182 He respectively Second locking plug-in unit 183.Retainer 786 can include upper wall 31a and lower wall 31b, and this upper wall is relative to lateral A angularly Skew is to limit upper inclined surface 184a, and this lower wall angularly offsets relative to lateral A to limit lower nauropemeter Face 184b.According to shown embodiment, plug-in unit 182 and 183 is configured between locked configuration and unlocked configuration change. For example, leg 779a and 779b is flexible so that permission plug-in unit 183 biases between unlocked configuration (not shown) and locked configuration, Carry 32 can move along retainer 786 in unlocked configuration, engage simultaneously with the tooth 778 of plug-in unit 182 with tooth 48 in locked configuration And band 32 is attached to retainer 786.Inclined surface 184a and 184b provides space with inclined from locked configuration for plug-in unit 182 and 183 It is pressed onto unlocked configuration.In addition, use two plug-in units 182 and 183 allow band tooth 48 and the tooth 778 locking plug-in unit 182 and 183 and 781 engage but regardless of apparatus 722 is relative to the mode with 32 orientations, above in relation to as described in apparatus 22.

Forwarding Figure 15 to, the apparatus 822 of another embodiment according to the disclosure includes being configured to be held by retainer 886 The locked component of the locking plug-in unit 186 carrying.Apparatus 822 is similar to above-mentioned apparatus 22 and 722.Hereafter the description to apparatus 822 will Use the same reference numerals of the element the 22nd, total between 722 and 822 for apparatus.Locking plug-in unit 186 is configured in locking It is iterated between configuration and unlocked configuration.As it can be seen, plug-in unit 186 includes the locking main body with pair of leg 879 and 881 876.Leg 879 and 881 terminates at engagement member 883 and 885 respectively.Retainer 886 includes surface 817, this surface at least portion Ground is divided to limit room the 819th, wall 821a and 821b, and sloping portion 884.According to optional embodiment, interior retainer surface 817 Can limit the engagement member 893 and 895 of a pair complementary shape, it receives engagement member 883 and 885 respectively, thus will lock group Part 874 is connected to retainer 886.As noted before, leg 879 and 881 can for flexible allowing plug-in unit 186 in locked configuration and Bias between unlocked configuration, as mentioned above.

Referring now to Figure 16 A and Figure 16 B, the apparatus 922 of another embodiment according to the disclosure is configured to permit The attachment part of implant 24 is optionally discharged from retainer 986.Apparatus 922 is similar to above-mentioned apparatus 22, therefore hereafter To the description of apparatus 922 use is used for element (such as actuator 82 and supporting structure total between apparatus 22 and apparatus 992 Part 84 and cutting assembly 120) same reference numerals.According to shown embodiment, retainer 986 can include one or Multiple release actuators 190, it is optionally 1 years old) locked component 972 and therefore retainer 986 are connected to implant 24 By receiving portion, and 2) make locked component 972 being departed from by receiving portion from implant 24.Locked component 972 includes locking Component 974.Locking component 974 includes leg 979a and 979b and tooth 978.As shown in Figure 16 A and Figure 16 B, actuator 190 is joined Being set to lever 191, this lever is upwards biased away from holding wall 923 so that keep wall 923 and lever 191 to limit gap 192.Lever 191 includes upper surface 193a and the lower surface 193b towards holding wall 923.Upper surface 193a limits room 919 He Engagement concave portions 196 (one of numbering), this engagement concave portions receives leg 779a and 779b of locking component 972 and is joined Receive lever 191.Lever 191 includes actuation tab 194, and this actuation tab stretches out from retainer 986 and passes through supporting Slit (not shown) in component 84.When actuation tab 194 laterally direction A is towards when keeping wall 923 to be pressed, lock structure Part 974 is from band 32 disengaging so that tooth 48 is disengaged with the tooth 978 of locking component 974.When locking component 974 is from implant 24 During disengaging, apparatus 922 can advance along distal direction 9 and/or proximal direction 7 along band 32 as required.When actuation tab 194 quilt During release, lever 191 is towards band 32 bias so that the tooth 178 of locking component 974 engages the tooth 48 with 32.

Forwarding Figure 17 to, the apparatus 942 of another embodiment according to the disclosure is configured to permit implant 24 Attachment part optionally discharges from retainer 986.Apparatus 942 is similar to above-mentioned apparatus 922, and hereafter to apparatus 942 Describe and use is used for element (such as actuator the 82nd, supporting member 84 and cutting group total between apparatus 922 and apparatus 942 Part 120) same reference numerals.According to optional embodiment, retainer 986 includes being configured to move locking component 975 Move the lever 990 of the joint engaging with 32 and departing from and with 32.Retainer 986 includes distal end 916, and couples Distal end 916 is connected to lever 990 by device 997.Lever 990 includes upper surface 993, this upper surface limit depressed part 995a and 995b is for receiving leg 979a and 979b of locking component 975.

Forwarding Figure 18 A to, another embodiment of apparatus 1022 is configured similarly to above-mentioned apparatus 22.Below with respect to Use is used for the reference number of the total element of apparatus 22 and 1022 by the description of apparatus 1022.According to shown embodiment party Case, apparatus 1022 includes limiter assembly 195, and when actuator 82 is in actuated, this limiter assembly operates to limit Retainer 1086 is along the displacement of proximal direction 7.For example, when retainer 1086 is attached implant 24 and actuator 82 activated with Just by retainer 1086 relative to supporting member 84 along proximal direction 7 translate when, force-limiting device assembly 195 prevents supporting member 84 And the increase further of the distance X (not shown) between the selection position 85 of actuator 82, this prevents retainer 86 and implant The displacement further of the retaining portion of 24.Therefore, limiter assembly 195 can prevent implant 24 around bone segment 28a and 28b mistake Degree is tightened.In osteoporotic bone, for example, there is band 32 to be drawn through locking mechanism 38 to the collar 55 and cut bone segment The risk of the degree in 28a and 28b.Force-limiting device assembly 195 is configured to prevent carrying 32 to be advanced through locking mechanism 38 and exceedes Bone fixation member 24 can cut the point in bone at which.

The power limiter assembly 195 being shown in Figure 18 A can include being releasably attached to the first of the second release component 196b Release component 196a.First release component 196a and the second release component 196b couples, as above during the operation of apparatus 1022 Described, it is further configured to depart from when the power applying along retainer 1086 exceedes predetermined threshold value.For example, threshold value can be 420N.Threshold value can adjust as required, and therefore can be higher or lower than 420N.The proximal end 1014 of retainer 1086 can limit Determine the first release component 196a, and the proximal end 68 of apparatus 1022 can limit the second release component 196b.Specifically, device Tool 1022 can include that L along the longitudinal direction extends outwardly away from the prominent of the selection position 85 of actuator 82 towards protuberance proximal end 198 Go out portion 197.Protuberance 197 can extend to the form in bent recess portion in protuberance 197 along proximal direction 7 and limit second and release Put component 196b.First release component 196b can be configured to bent node, and this bent node has and limits with by protuberance 197 The complementary shape in bent recess portion.When retainer 86 is connected to implement body 64, protuberance proximal end 198 can at least portion Ground is divided to extend around bent node.Should be understood, although the first release component 196b can limit bent node and the second release Component 196b can limit bent recess portion, but the first release component 196a also can limit bent recess portion and the second release component 196b can limit bent node.For example, any one limited bent recess portion in retainer or implement body.In addition, keep Any one limited bent node in device or actuator.

With continued reference to Figure 18 A, in operation, the retaining portion at retainer 1086 and implant 24 moves to retracted position When in (not shown), when the pulling force applying along retainer 86 exceedes predetermined threshold value, the first release component 196a and Two release component 196b depart from.As noted before, when 1) retainer 86 is attached to implant 24 and 2) power F1, F2 is along side It is applied to actuator 82 to direction A so that when retainer 1086 moves in retracted position relative to supporting member 84, apparatus 922 apply pulling force along retainer 86 and implant 24 along distal direction 9.Up to predefine threshold value with putting forth effort to increase to, prominent Go out portion's proximal end 198 outwards bias and discharge bent node 196a from bent recess portion 196b.When bent node 196a quilt During release, retainer 1086 is no longer coupled to the proximal end 68 of implement body 64 and will be no longer flat relative to supporting member 84 Move.Thus, the first release component 196a and the second release component 196b is configured to force-limiting device assembly 195.

Forwarding Figure 18 B to, apparatus 1062 is configured similarly to above-mentioned apparatus 22 and 1022.According to optional embodiment, Apparatus 1062 can include the force-limiting device assembly 1095 according to another embodiment.Force-limiting device assembly 1095 can be configured to Biasing member 1097, when actuator is in the second configuration or actuated, this biasing member can resist actuator 82 along nearside The displacement in direction 7.For example, when retainer 2086 is attached implant 24 and actuator 82 is actuated to retainer 2086 phase When translating for supporting member 84 L in a longitudinal direction, force-limiting device assembly 1095 can prevent the shifting further of retainer 2086 Position.According to shown embodiment, the proximal end 2014 of retainer 2086 is connected to apparatus 1062 by biasing member 1097 Proximal end 68.Biasing member 1097 can limit from the proximal end 2014 of retainer 2086 towards the extension of selection position 85 Its length S1 (not shown).Biasing member 1097 can be for being configured to operate as stretching the curved body that spring works.At it In his embodiment, biasing member 1097 can be the spiral being connected between the proximal end 2014 of retainer 86 and actuator 82 Stretching spring.Biasing member 1097 can be any other structure of deforming in response to the load being applied or device.In operation In, the force-limiting device assembly 1095 being shown in Figure 18 B is configured to restriction and is applied to retainer 2086 by biasing member 1097 And it is therefore applied to the power of implant 24.As noted before, as the power applying along retainer 86 increases, biasing member 1097 extend to the second its length S2 (not shown) more than the first its length S1 from the first its length S1.Biasing member 497 can be configured to have when pulling force reaches predetermined threshold value limit the spring constant that retainer 2086 translates further, Biasing member 1097 is made to be not extended past its length S2.It should be appreciated that any kind of biasing member can be employed as power limit Device processed.

Turning now to Figure 19 to Figure 25, other embodiments of the disclosure include bone fixation system 200 and 300.Bone is fixed System 200 and 300 includes corresponding bone fixation implant 210 and 310, and it is each configured to by the first bone segment 204 (such as Bone flap) it is fixed to the second bone segment 206 (such as opening the skull after cranium art).Bone fixation system 200 and 300 includes apparatus respectively 250 and 350, it is configured to pulling force be applied to implant 210 and 310 with against bone segment fixation implant 210 and 310.

Seeing Figure 19-Figure 22, bone fixation system 200 can include bone fixation implant 210 and tensioning apparatus 250, this tensioning Apparatus is configured to force bone fixation implant to enter clamping configuration against bone segment 204 and 206.Bone fixation implant 210 can Being configured to cranial flap clamp, this cranial flap clamp includes the first clamper component the 212nd, the second clamper component 214, and from the first fixture Component 212 along a first direction 201 extend connection element 216, this connection element relative to the first clamper component 212 towards The outer surface of bone angularly offsets.Connection element 216 is configured to be coupled to the actuator 252 of tensioning apparatus 250.Bone is fixed Implant 210 can be made up of any material being applicable to medical application, such as stainless steel, titanium, titanium-base alloy or absorbable polymerization Thing material.

See Figure 20, the first clamper component 212 can include having first surface or inner surface 218 and second surface or towards First jig main body 213 of the outer surface 220 of bone.Inner surface 218 can be convex, and outer surface 220 can be spill.Towards The outer surface 220 of bone can include one or more soldered tooth 221, this soldered tooth be configured to respectively with bone segment 204 and 206 Inner surface 205a and 205b engages.

Second clamper component 214 includes the second jig main body 217, and this second jig main body limits the inner surface towards bone 228 outer surfaces 230 relative with the inner surface 228 towards bone, and the bore hole 232 extending along axis of bore 207.Main body 217 include the wall 237 limiting bore hole 232.Second jig main body 217 can limit stayed surface 269.Wall 237 carrying extends to boring Locking component 236 in hole 232.Locking component 236 can be for towards the prominent one or more soldered tooths 238 of axis of bore 207. In addition, the inner surface 228 towards bone of the second clamper component 214 can carry soldered tooth 239, this soldered tooth is towards outside bone Surface 209 and 211 extends along the direction towards the first clamper component 212.Soldered tooth 239 can respectively with bone segment 204 and 206 Outer surface 209 and 211 engage.

Referring now to Figure 19 and Figure 20, connection element 216 extends from the first clamper component 212 along proximal direction 7.According to Shown embodiment, the bore hole 232 that connection element 216 passes through the second jig main body 217 from the first jig main body 213 prolongs Stretch, and selecting to be attached to actuator 252 at 185s, position.Connection element 216 can include limiting one or more soldered tooth The outer surface 234 of 235a and recess 235b.When connection element 216 extends through bore hole 232, wall soldered tooth 238 engage by The recess 235b that connection element 216 limits.Tooth 235a and 238 is configured so that connection element 216 can be along axis 203 along closely Side translates across bore hole 232 to 7, prevents connection element 216 from translating along relative distal direction 9 simultaneously.Connection element 216 can Integral with the first jig main body 213, or it can use any number of known method to be attached to the first jig main body 213.

Tensioning apparatus 250 includes supporting member 254 and along the proximal direction 7 and supporting member 254 with longitudinal direction L alignment The actuator 252 being spaced apart.Tensioning apparatus 250 includes implement body 262, and this implement body limits distal end 264, Yi Jiyan The proximal end 266 that longitudinal direction L is spaced apart with distal end 264.Actuator 252 proximally end 266 extends to supporting Component 254.Apparatus distal end 264 can limit supporting member 254.As described above, actuator 252 can limit selection position 185, This selection position can thus be attached to actuator 252 and the position extending from actuator 252 for connection element 216.Apparatus 250 Can include cutting assembly, this cutting assembly includes at least one blade 101, and this blade is carried and joined by supporting member 254 It is set to when bone fixation implant 210 has been forced into clamping configuration (Figure 21) cut the maintaining part of bone fixation implant 210 Divide (or connection element).In addition, apparatus 250 can include limiter that is similarly as described above and that be shown in Figure 18 A and Figure 18 B The limiter assembly of assembly 195 and 1095.

Actuator 252 is configured in response to the applying of compression stress F1 and F2 and is transformed into the second actuating structure from the first configuration Type, in the first configuration, a part for actuator 252 is spaced apart along the direction being perpendicular to proximal direction with retainer, causes second In dynamic configuration, the part deformation of actuator is to increase the distance selecting between position 185 and supporting member 254.Actuator 252 Including flexible portion 289, this flexible portion deforms when being applied to power F1 and F2 on it.Actuator flexible portion 289 includes First actuating component or the first arm 270 and second actuating component relative with the first actuating component 270 or the second arm 272.Root According to shown embodiment, when compression stress F1, F2 are applied to actuator 252, the first actuating component 270 and second activates Component 272 can bend along each actuating component in spaced apart position.Therefore, the first actuating component 270 and second activates Component 272 can include one or more joints 274 (not shown), such as multiple joints.First actuating component 270 and second activates Component 272 includes proximal end 277a and 277b and relative distal end 278a and 278b respectively.Actuating component proximal end Portion 277a and 277b can be disposed adjacent with the proximal end 266 of implement body, and actuating component distal end 278a and 278b Can be adjacent with supporting member 254.In alternative embodiments, the first actuating component 270 and the second actuating component 272 are flexible It to extend along axis of bending, is similar to relative to the actuating component 74 and 76 described in apparatus 22.Therefore actuator 252 can have There is analog structure and the function being similar to actuator 82.

Forwarding Figure 20 to, supporting member 254 is configured to the stayed surface 269 of adjacent second jig main body 217 to support Apparatus 250 is for activating and shifting the connection element 216 of attachment.The supporting member 254 of apparatus 250 includes the wall being spaced apart 280 and 282.Wall 280 and 282 limit passage 285, this passage L in a longitudinal direction extend and its be sized to and It is configured to receive a part for bone fixation implant 210, such as connection element 216.At least wall 280 and 282 can carry one To blade, such as a pair blade 100.Implement body 262 also includes the gripping structure extending from wall 280 and 282 laterally direction A Part 284a and 284b (Figure 19).

Seeing Figure 19-Figure 22, connection element 216 can be elongated and limit proximal end further along axis 203 286 and the distal end 288 that is spaced apart with proximal end 286 along axis 203.Connection element proximal end 286 can be connected to The position 185 of actuator 252.Connection element distal end 288 could attach to the first jig main body 213 or is integral with.? In optional embodiment, apparatus 250 can include the retainer extending from position 185 towards supporting member.In such enforcement In scheme, connection element proximal end 286 could attach to retainer.

Forward Figure 21 and Figure 22 to, implement body 262 can limited hole 241, this through hole be sized to receive couple Element proximal end 286.Implement body 262 includes body outer surface 263a, body inner surface 263b, and at body outer surface Lateral surfaces 263c extending between 263a and body inner surface 263b.Lateral surfaces limited hole 241.Through hole 241 includes closely Side part 242a and distal part 242b being spaced apart towards distal end 268 with portions of proximal 242a along axis 203.Device Tool main body 262 includes opposite flank 267a and 267b being spaced apart along horizontal direction T.Chamber 244 is from surface 267b transversely Direction T extends towards surface 267a, and extends to limit and opening from surface 263b along apparatus longitudinal direction L towards surface 263a Put chamber 244.For example, chamber 244 is open to limit U-shaped chamber (Figure 20 b).The portions of proximal of through hole 241 therefore limited hole 241 Neck 245 between 242a and distal part 242b.Chamber 244 have from first along surface 263c extend to laterally side First cross sectional dimensions Z of the corresponding point on the surface 263c of A.The proximal end 286 of connection element 216 carries size and is set Determine into the stretching, extension supporting member 246 coordinating in chamber 244.When stretching supporting member 246 and resting upon in chamber 244, connection element 216 are connected to implement body 262 so that compressive activation device 252 causes connection element 216 flat along axis 203 along proximal direction 7 Move, thus bone segment 204 and 206 is clamped between the first clamper component 212 and the second clamper component 214.In addition, because chamber 244 is open along side surface 267b, thus supporting member 246 can be biased into as required engage with implement body 262 and It is disengaged.For example, connection element 216 is insertable through the bore hole 232 of the second implant component 214 and enters in chamber 244.

According to embodiment, apparatus 250 is configured so that when relative compressive force F1 and F2 laterally direction A is applied to During the flexible portion 289 of actuator 252, connection element 216 relative to supporting member 254 along proximal direction the 7th, 201 displacement.Couple Element 216 forces the first clamper component 212 and the second clamper component 214 toward each other along the displacement of proximal direction 7.

Turning now to Figure 23-Figure 25, bone fixation system 300 includes bone fixation implant 310 and tensioning apparatus 350, this Tight apparatus is configured to force bone fixation implant 310 to enter clamping configuration against bone segment 204 and 206.Bone fixation implant 310 include the first clamper component or interior clamper component 312 and the second clamper component or outer clamper component 314.Bone is fixing to be implanted Thing 310 can include fixture conjugative component 311, and this fixture conjugative component extends from interior clamper component 312 and is configured to engage Second clamper component 314.Bone fixation implant 310 can be made up of any suitable biocompatible materials as noted above.

Forwarding Figure 23 and Figure 24 to, according to shown embodiment, the first clamper component 312 includes having inner surface 318 The first jig main body 313 with the outer surface 320 towards bone.Inner surface 318 can be convex, and outer surface 320 can be spill 's.Outer surface 320 can include one or more soldered tooth (not shown), and this soldered tooth is configured to and bone segment 204 and 206 Inner surface 205a and 205b engages.First jig main body 313 limits the through hole 338 extending along axis 203.The size quilt of through hole It is set to the distal end 388 of instruments 350, such as retainer 356.Through hole 338 include portions of proximal 339a and along Distal part 339b that axis 203 is spaced apart with portions of proximal 339a.Distal part 339a limits chamber 340.

With continued reference to Figure 23 and Figure 24, the second clamper component 314 includes the second jig main body 317, this second jig main body Limit the inner surface 328 towards bone and the outer surface 330 relative with the inner surface 328 towards bone.Second jig main body 317 limits Center opening 332c, and this central opening is directed at along the through hole 338 of axis 203 and the first jig main body 313, and first opens Mouth 332a and the second opening 332b is spaced apart with central opening 332c.Central opening 332c may pass through wherein catch-holder 356. First opening 332a and the second opening 332b extends along bending axis of bore (not shown) along the direction away from axis 203.The Two jig main bodies 317 include a pair guiding elements 335a and 335b, and it is connected to main body 317 or integral with main body 317, and It is configured to cross over opening 332a and 332b (Figure 25), and be spaced apart to limit and open with the outer surface of clamper component 314 The respective paths of mouth 332a and 332c alignment.First opening 332a and the second opening 332b is configured to receive and guide engagement group Part 311.

According to shown embodiment, conjugative component 311 is integral with the first clamper component 312 or it could attach to First clamper component 312 and can extend across the second clamper component 314.Fixture conjugative component 311 includes that at least one is flexible Component, the such as first flexible member 316a and the second flexible member 316b.First flexible member 316a and the second flexible member 316b is configured to extend respectively through the first opening 332a of the second clamper component 314 and the second opening 332b.Because first Flexible member 316a and the second flexible member 316b is similarly configured, so only describing flexible structure for convenience of description herein Part 316a.Flexible member 316a includes main body 319, and this main body includes what the 322nd, base portion was spaced apart along axis 321 with base portion 322 Terminal 324, and outer surface (unnumbered).Main body 319 can carry one or more engagement member 326, such as tooth.Engagement member 326 are configured to be coupled to the second clamper component 314.For example, engagement member 326 can with in opening 332 or guiding elements 335a The second jig main body 317 inner surface (unnumbered) engage.Engagement member 326 is configured to be coupled to the second clamper component 314, in order to 1) allow flexible member 316a translate across opening 332a, and 2 in the first direction along axis of bore) prevent soft Property component 316a inverted orientation and translate out opening 332a along the second direction contrary with first direction.

Tensioning apparatus 350 is configured to be attached to a part for implant 310, and after the actuating of apparatus, forces First clamper component 312 and the second clamper component 314 are toward each other to be clamped together bone segment 204 and 206.Apparatus 350 are similar to above-mentioned apparatus 22 and apparatus 250.For example, apparatus 350 include supporting member 354 and along the longitudinal direction L with supporting structure The actuator 352 that part 354 is spaced apart, and retainer 356, this retainer is from the position 385 of actuator 352 towards supporting member 354 extend and are configured to be attached to a part for bone implant 310.Being different from wherein connection element 216 can be implant The above-mentioned apparatus 250 of the parts of 210, retainer 356 can be the parts of apparatus 350 and could attach to implant 310.In addition, Apparatus 350 can include cutting assembly, such as blade 101, and this blade is configured to be forced at bone fixation implant 310 The part of retainer 356 is cut after clamping configuration.Apparatus may also comprise similarly as described above and is shown in Figure 18 A and figure The force-limiting device assembly of the force-limiting device 195 and 1095 in 18B.

Apparatus 350 includes implement body 362, and this implement body includes that L is spaced apart with supporting member 354 in a longitudinal direction Proximal end 366 so that main body 362 limits at least a portion of actuator 352 and at least a portion of supporting member 354. Supporting member 354 includes distal surface 368, this distal surface be configured to actuator 352 is as described below activated when adjacent The stayed surface 369 of the second clamper component 314 and against the second clamper component fixing device 350.

Actuator 352 can include flexible portion 389, and this flexible portion deformable is to cause position 385 along proximal direction 7 Move away from supporting member 354.Position 185 and supporting member 354 can be limited to the distance extending between the two, above in conjunction with apparatus Described in 22 and Fig. 4 A-Fig. 4 D.Therefore, the deformation of actuator 352 (and in particular to flexible portion 389) causes position 185 With the distance between supporting member 354 increases.

Flexible portion 389 can include the first actuating component 370 and the second actuating component 372.First actuating component 370 and Two actuating component 372 are flexible to extend along axis of bending relative to the some (not shown) being limited by retainer 356.Activate Therefore device 352 can be transformed into actuated from the first configuration, the first actuating component 370 and the second actuating component in the first configuration 372 are spaced apart with retainer 356 and have the first shape or curved shape, and in actuated, actuating component 370 and 372 becomes Shape and there is the shape of the second shape or more linear and position towards retainer 356.In alternative embodiments, One actuating component 370 and the second actuating component 372 can include at least one joint (not shown), such as multiple joints.Therefore, Construction and the function of one actuating component 370 and the second actuating component 372 can be similar to above in relation to first described in apparatus 22 Actuating component 72 and the second actuating component 74.

According to shown embodiment, retainer 356 is from the proximal end 366 of implement body 362 towards supporting member 354 extend through opening 332c and couple the first clamper component 312.Retainer 356 is elongated along axis 203 and enters One step limits retainer proximal end 386 and the retainer distal end portion being spaced apart along axis 203 with retainer proximal end 386 Portion 388.Retainer distal end 388 is attached to the first clamper component.The distal end 388 of retainer 356 includes that size is set Determine into the amplifier section 346 coordinating in the chamber 340 of the first clamper component 312.

With continued reference to Figure 23 and Figure 24, in operation, when actuator 352 is in the first configuration, supporting member 368 can be adjacent Connect the surface 369 of the second implant component 314.Make flexible portion 389 along the direction compressive activation device 352 towards retainer 356 Deform and cause position 185 to be displaced away from supporting member 354.The displacement of the position 185 of actuator 352 causes retainer 356 Translate across opening 332c relative to supporting member 354 along proximal direction 7.Then the distal end 388 of retainer 356 forces One clamper component 312 advances towards bone surface 205, and the second clamper component 314 advances towards relative bone surface 209 and 211. When retainer 356 translates across the second clamper component 314, flexible member 316a and 316 translates across corresponding opening 332a Slide away from axis 203 with 332b and along surface 330 so that terminal 322a and 332b are towards the periphery of clamper component 314 Limit is orientated, thus is positioned at bone fixation implant 310 in clamping configuration.Hereafter, apparatus 350 can around axis 203 rotate with Cause blade 101 to cut retainer 356, thus leave the bone fixation implant 310 of implantation, as shown in figure 25.Cutting retainer The alternative means of 356 is supporting member 346 to bias disengaging pass through opening 332c with joint and the tractive retainer in chamber 340. In such embodiments, conjugative component 311 is configured to the first clamper component 312 is locked onto the second clamper component 314.

Relative to bone implant 210 and 310 that is mentioned above and that be shown in Figure 19-Figure 25, mention " first " or " Two " be for illustrate bone fixation system the 210th, 310 the purpose of each embodiment.Therefore, the 212nd, interior clamper component 312 can claim For implant the 210th, 310 the first clamper component or Part I, and the 210th, the 214th, outer clamper component 314 can be described as implant Second clamper component of 310 or Part II.Or, interior clamper component the 212nd, 312 can be described as implant the 210th, 310 second folder Tool component or Part II, and outer clamper component the 214th, 314 can be described as implant the 210th, 310 the first clamper component or first Point.

The method that another embodiment of the disclosure can include applying tension force to element.Element can be implant or implantation A part for thing, all as shown in the implant 24 in Fig. 1-Figure 18 B so that can to use in the apparatus being shown in Fig. 1 to Figure 18 B Any one performs the method.Additionally, element can be to be shown as the implant with the bone fixation system 300 being shown in Figure 23-Figure 25, Make to use the apparatus 350 being shown in Figure 23-Figure 25 to perform the method.Method includes that the Part I of rest element is placed Supporting member, such as supporting member 84 or any other similar supporting member.The Part II of element can be connected to retainer, Such as retainer 86, or other similar retainers any of the above described.When the Part II of element is connected to retainer, retainer Extend from the position of the actuator being spaced apart with supporting member along proximal direction.Actuator can be similar to actuator 82 or above-mentioned its The actuator that he is similar to.Method can comprise the following steps：Actuating power is applied to towards retainer the part of actuator, thus leads Cause actuator deform and make the position of actuator and retainer move along proximal direction relative to supporting member, thus by pulling force It is applied to the Part II of element.Applying step may also include and relative to supporting member, retainer is moved to edge from primary importance The second place that proximal direction is spaced apart with primary importance, thus pulling force is applied to the Part II of element.Method can include Limit the further movement of step relative to supporting member for the retainer.According to the particular of method, element is that bone is solid Determining component, wherein the Part I of element is lock, and the Part II of element is band.It is shown in Figure 23-Figure 25 according to for use In bone fixation system apply tension to the embodiment of method of element, element is implant, and the first bone implant Part I be configured to the first surface towards bone, Part II be arranged to towards bone with first surface back to The second bone implant of second surface.Such method can include being connected to retainer the second bone implant.

Another embodiment of the disclosure includes using the bone fixation system being shown in Figure 19-Figure 22 to fix implant To the method for bone, this bone fixation system includes implant, and this implant has and is configured to first of the first surface towards bone Part, be configured to towards bone with first surface back to the Part II of second surface, and from the second of implant Extend partially across the connection element of Part I.According to such embodiment, method includes first against implant Divide and place supporting member.Method includes being attached to connection element in the position being spaced apart with supporting member along proximal direction cause Dynamic device so that the flexible portion of actuator is spaced apart along the direction being perpendicular to proximal direction with connection element.Method includes causing Power is applied to the flexible portion of actuator towards connection element, and this causes actuator to couple element relative to supporting member edge Proximal direction moves, thus forces the Part I of the Part II of implant towards implant.

Claims (according to the modification of treaty the 19th article)

1. an apparatus, including：

Supporting member；

Actuator, described actuator is spaced apart along proximal direction with described supporting member, and described actuator includes flexible portion；With

Retainer, described retainer is configured to be attached to a part for implant, and described retainer is from described actuator Being positioned against described supporting member to extend, described position is spaced a distance with described supporting member along described proximal direction,

Wherein exerting a force to described actuator makes described flexible portion deform, in order to increase described position and described supporting member Between distance.

2. apparatus according to claim 1, wherein when being applied to described actuator by described power towards described retainer During described flexible portion, the deformation of the described flexible portion of described actuator, in order to increase described position and described supporting member it Between distance.

3. apparatus according to claim 1, wherein in response to the described power being applied to described actuator, described actuator from First configuration is converted to the second actuated, and in described first configuration, described retainer is in relative to described supporting member Primary importance, in described second actuated, described retainer is in along the described nearside side of restriction relative to supporting member To the second place that is spaced apart with primary importance of longitudinal direction.

4. apparatus according to claim 2, wherein said actuator is configured so that the deformation of described flexible portion is led Causing described distance increases along described longitudinal direction.

5. apparatus according to claim 1, wherein said actuator includes along described proximal direction and described supporting member The proximal end being spaced apart, described proximal end includes described position, and wherein said flexible portion is connected to described actuator Described proximal end and be connected to described supporting member so that when described flexible portion deforms, described actuator described Proximal end shifts relative to described supporting member, thus increases the distance between described position and described supporting member.

6. apparatus according to claim 1, the described flexible portion of wherein said actuator include the first actuating component and Second actuating component, described second actuating component edge is perpendicular to the direction of described proximal direction and described first actuating component phase Right.

7. apparatus according to claim 6, wherein said first actuating component and described second actuating component are along accordingly First axle and the second axis are elongated, wherein when described actuator is in described first configuration, and described first actuating structure Part and described second actuating component each bend so that each axis in described first axle and described second axis limits phase Answer curvature, and when described actuator is in described second actuated, described first actuating component and described second activates The deformation of member so that the described corresponding curvature of described first axle and described second axis reduces.

8. apparatus according to claim 6, wherein said first actuating component and described second actuating component each include At least one joint, and described first actuating component and described second actuating component can be at least one joints described Each joint bends, in order to cause described actuator to be converted to described second actuated from described first configuration.

9. apparatus according to claim 8, wherein said first actuating component and described second actuating component each include At least one adjacent rigid member of a joint corresponding at least one joint described, at least one rigidity wherein said The flexibility of component is less than at least one joint described.

10. apparatus according to any one of claim 1 to 9, wherein said retainer includes at least one locking component, At least one locking component described is configured to the described part of described implant is attached to described retainer.

11. apparatuses according to claim 10, it is described that at least one locking component wherein said carrying is configured to joint One group of tooth of the described part of implant.

12. apparatuses according to according to any one of claim 1 to 11, also include discharging actuator, described release actuator quilt It is configured to described implant when described retainer is attached to the described part of described implant from described retainer selectivity Ground release.

13. apparatuses according to according to any one of claim 1 to 12, wherein said supporting member limits receiver, described connects That receives device is sized to receive a part for described retainer.

14. apparatuses according to according to any one of claim 1 to 13, wherein said supporting member carries at least one blade, Described blade is configured to cut described in described implant when the described part of described implant is attached to described retainer Part.

15. apparatuses according to according to any one of claim 1 to 13, also include the cutting group being supported by described supporting member Part, described cutting assembly includes at least one blade and blade actuator, wherein when described retainer is attached to described implant When, the actuating of described blade actuator causes the described implant of described at least one blade cutting.

16. apparatuses according to according to any one of claim 1 to 15, the described part of wherein said implant is first Dividing, and described implant including Part II, wherein said apparatus also includes removable stabilizing member, described stabilizing member quilt It is configured to the described Part II of described implant is connected to described supporting member so that described first of described implant Divide and can be attached to described retainer.

17. apparatuses according to according to any one of claim 2 to 16, also include force-limiting device, and described force-limiting device is configured Become when described retainer is attached to the described part of described implant, exceeding predetermined along the power of described retainer Prevent actuator from increasing the distance between the described position of described actuator and described supporting member during power threshold value.

18. apparatuses according to according to any one of claim 1 to 17, wherein said retainer is integral with described actuator.

19. apparatuses according to according to any one of claim 1 to 18, wherein said implant is cable strap, described cable strap Including lock and the band from described lock extension, and described retainer is configured to be attached to described band.

20. 1 kinds of bone fixation systems, including：

Apparatus according to according to any one of claim 1 to 19；With

Bone fixation member, described bone fixation member includes locking mechanism and the flexible member extending from described locking mechanism, described Flexible member limits main body, and described main body limits terminal, and described terminal is configured to extend through described locking mechanism, in order to limit Surely be arranged on the collar at the first side of described locking mechanism, wherein said terminal extend outwardly away from described locking mechanism with described The second relative side of described first side of locking mechanism simultaneously enters in described retainer.

Claims

1. an apparatus, including：

Supporting member；

6. apparatus according to claim 3, wherein release is applied to the described power of the described flexible portion of described actuator Described actuator is allowed to return to described first configuration so that retainer returns towards described primary importance.

7. apparatus according to claim 1, wherein release is applied to the described power of the described flexible portion of described actuator Described actuator is allowed to reduce the distance between described position and described supporting member.

8. apparatus according to claim 1, the described flexible portion of wherein said actuator include the first actuating component and Second actuating component, described second actuating component edge is perpendicular to the direction of described proximal direction and described first actuating component phase Right.

9. apparatus according to claim 8, wherein said first actuating component and described second actuating component are along accordingly First axle and the second axis are elongated, wherein when described actuator is in described first configuration, and described first actuating structure Part and described second actuating component each bend so that each axis in described first axle and described second axis limits phase Answer curvature, and when described actuator is in described second actuated, described first actuating component and described second activates The deformation of member so that the described corresponding curvature of described first axle and described second axis reduces.

10. apparatus according to claim 8, wherein said first actuating component and described second actuating component each include At least one joint, and described first actuating component and described second actuating component can be at least one joints described Each joint bends, in order to cause described actuator to be converted to described second actuated from described first configuration.

11. apparatuses according to claim 10, wherein said first actuating component and described second actuating component are each wrapped Including at least one adjacent rigid member of a joint corresponding at least one joint described, wherein said at least one is firm Property component flexibility be less than at least one joint described.

12. apparatuses according to claim 8, wherein said first actuating component and described second actuating component each include The first end being disposed adjacent with described position and the second end being disposed adjacent with described supporting member.

13. apparatuses according to according to any one of claim 1 to 12, wherein said retainer includes at least one locking structure Part, at least one locking component described is configured to the described part of described implant is attached to described retainer.

14. apparatuses according to claim 13, it is described that at least one locking component wherein said carrying is configured to joint One group of tooth of the described part of implant.

15. apparatuses according to according to any one of claim 1 to 14, also include discharging actuator, described release actuator quilt It is configured to described implant when described retainer is attached to the described part of described implant from described retainer selectivity Ground release.

16. apparatuses according to according to any one of claim 1 to 15, wherein said supporting member limits receiver, described connects That receives device is sized to receive a part for described retainer.

17. apparatuses according to according to any one of claim 1 to 16, wherein said supporting member carries at least one blade, Described blade is configured to cut described in described implant when the described part of described implant is attached to described retainer Part.

18. apparatuses according to according to any one of claim 1 to 16, also include the cutting group being supported by described supporting member Part, described cutting assembly includes at least one blade and blade actuator, wherein when described retainer is attached to described implant When, the actuating of described blade actuator causes the described implant of described at least one blade cutting.

19. apparatuses according to claim 18, wherein said blade actuator is rotating parts, wherein said rotatable The rotation of component causes the described part being attached to described retainer of the described implant of described at least one blade cutting.

20. apparatuses according to claim 18, wherein said blade actuator is lever, described in the carrying of described lever at least One blade, described lever is configured to be pressed, in order to cause the attachment of the described implant of described at least one blade cutting Described part to described retainer.

21. apparatuses according to according to any one of claim 1 to 20, the described part of wherein said implant is first Dividing, and described implant including Part II, wherein said apparatus also includes removable stabilizing member, described stabilizing member quilt It is configured to the described Part II of described implant is connected to described supporting member so that described first of described implant Divide and can be attached to described retainer.

22. apparatuses according to according to any one of claim 2 to 21, also include force-limiting device, and described force-limiting device is configured Become when described retainer is attached to the described part of described implant, exceeding predetermined along the power of described retainer Prevent actuator from increasing the distance between the described position of described actuator and described supporting member during power threshold value.

23. apparatuses according to according to any one of claim 22, described retainer is connected to institute by wherein said force-limiting device State the described position of actuator.

24. apparatuses according to claim 23, wherein said force-limiting device is release component and biasing member.

25. apparatuses according to claim 23, wherein said force-limiting device is biasing member.

26. apparatuses according to according to any one of claim 1 to 25, wherein said retainer is integral with described actuator.

27. apparatuses according to according to any one of claim 1 to 26, wherein said implant is cable strap, described cable strap Including lock and the band from described lock extension, and described retainer is configured to be attached to described band.

28. 1 kinds of bone fixation systems, including：

Apparatus according to according to any one of claim 1 to 26；With

29. 1 kinds of bone fixation systems, including：

First clamper component, described first clamper component is configured to the first surface towards bone；

Second clamper component, described second clamper component be configured to towards described bone with described first surface back to Two surfaces；With

Apparatus according to according to any one of claim 1 to 26, wherein said retainer is configured to extend through described Two clamper components are to be attached to described first clamper component.

30. 1 kinds of methods applying tension to element, said method comprising the steps of：

Supporting member is placed against the Part I of described element；

The Part II of described element is connected to retainer, described retainer from actuator along proximal direction and described supporting The position that component is spaced apart extends, and wherein said actuator has along the direction being perpendicular to described proximal direction and described interelement The part separating.

Actuating power is applied to the described part of described actuator, thus causes described actuator deform and make described actuator Described position and described retainer move along described proximal direction relative to described supporting member, thus pulling force is applied to institute State the described Part II of element.

31. methods according to claim 30, also include the described Part II of described element is attached to described holding The step of device.

32. methods according to claim 30, wherein said applying step includes described retainer from primary importance phase Described supporting member is moved to the second place being spaced apart along described proximal direction with described primary importance, thus by described Pulling force is applied to the described Part II of described element.

33. methods according to claim 30, also include limiting described retainer and enter one relative to described supporting member The step of moved further.

34. methods according to claim 30, the described part of wherein said actuator include the first actuating component and with Described actuating power is wherein applied to the described part of described actuator by the second relative actuating component of described first actuating component Step include making described first actuating component and described second actuating component towards described retainer along be perpendicular to described closely Side to described direction move.

35. methods according to according to any one of claim 30 to 34, wherein element is bone fixation member, the institute of described element Stating Part I is lock, and the described Part II of described element is band.

36. methods according to according to any one of claim 30 to 34, wherein said element is implant, described Part I Be arranged to the first bone implant of the first surface towards bone, described Part II be arranged to towards described bone with Described first surface back to the second bone implant of second surface, and described method also includes coupling described retainer Step to described second bone implant.

37. 1 kinds of apparatuses, including：

Supporting member；

Actuator, described actuator is spaced apart along proximal direction with described supporting member, and described actuator limits and is configured to prop up The position of the connection element of support implant, the described position of wherein said actuator is along described proximal direction and described supporting member Spaced a distance, described actuator includes flexible portion, and described flexible portion is relative to the described position of described actuator Along the first direction skew being perpendicular to described proximal direction so that exert a force to described actuator and cause described actuator to increase Distance between described position and described supporting member.

38. apparatuses according to claim 37, wherein said power applies along second direction opposite to the first direction To the described flexible portion of described actuator, described actuator increases the distance between described position and described supporting member.

39. apparatuses according to claim 37, wherein in response to the described power being applied to described flexible portion, described actuating Device is converted to the second actuated from the first configuration, and in described first configuration, described retainer is relative to described supporting member Being in primary importance, in described second actuated, described retainer is in along restriction described closely relative to supporting member Side to the second place that is spaced apart with primary importance of longitudinal direction.

40. apparatuses according to claim 37, wherein said actuator is configured so that the deformation of described flexible portion Described distance is caused to increase along described longitudinal direction.

41. apparatuses according to claim 37, wherein said actuator includes along described proximal direction and described supporting structure The proximal end that part is spaced apart, described proximal end limits described position, and wherein said flexible portion is connected to described actuator Described proximal end and be connected to described supporting member so that when described flexible portion deforms, the institute of described actuator State proximal end to shift relative to described supporting member, thus increase the distance between described position and described supporting member.

42. apparatuses according to claim 37, the described flexible portion of wherein said actuating component includes the first actuating structure Part and the second actuating component.

43. apparatuses according to according to any one of claim 37 to 39, also include following at least one：

Cutting assembly, described cutting assembly is configured to cut described retainer；With

Limiter, described limiter is configured to when connection element is attached to described actuator prevent actuator by described actuating Distance between the described position of device and described supporting member increases above predetermined distance threshold.

44. apparatuses according to according to any one of claim 37 to 42, wherein said connection element extends from described implant.

45. apparatuses according to according to any one of claim 37 to 42, wherein said connection element becomes one with described implant Body.

46. apparatuses according to according to any one of claim 37 to 42, wherein implant includes being attached to described connection element The first clamper component, described first clamper component is configured to the first surface towards described bone, and the second clamper component Be configured to towards described bone with described first surface back to second surface.

47. 1 kinds, for securing an implant to the method for bone, said method comprising the steps of：

Place supporting member against the Part I of described implant, the described Part I of described implant is configured to face To the first surface of bone, described implant include being configured to towards described bone with described first surface back to the second table The Part II in face, and the connection element of described Part I is extended through from the described Part II of described implant；

Described connection element is attached to described actuator in the position being spaced apart with described supporting member along proximal direction, makes The flexible portion obtaining actuator is spaced apart along the direction being perpendicular to described proximal direction with described connection element；And

Exert a force to the described flexible portion of described actuator, thus cause described actuator make described connection element relative to Described supporting member moves along described proximal direction, thus forces the described Part II of described implant towards described implant Described Part I.

48. methods according to claim 47, wherein said power is applied to described flexible portion towards described connection element.

49. methods according to claim 47, wherein said actuator includes the first actuating component and causes with described first Described actuating power is wherein applied to the step of the described flexible portion of described actuator by the second relative actuating component of dynamic component Including make described first actuating component and described second actuating component towards described connection element along being perpendicular to described nearside side To direction move.

50. methods according to claim 47, wherein said actuator includes each including the first of at least one joint The step that described actuating power is applied to described actuator is wherein caused described first to activate by actuating component and the second actuating component Component and described second actuating component bend to make described actuator deform at described at least one joint corresponding.

51. methods according to claim 47, wherein said actuator includes the first actuating component and the second actuating component, And each actuating component in described first actuating component and described second actuating component is bending.

52. methods according to according to any one of claim 47 to 49, also include the described Part II from described implant The step cutting described connection element.

53. methods according to claim 49, the described Part I of wherein said implant includes opening, and described Method also includes the step placing the described connection element of the described Part II of described implant through described opening.

54. methods according to according to any one of claim 47 to 53, the described Part I of wherein said implant includes First clamper component, and the described Part II of described implant includes the second implant component, wherein applies described actuating The step of power forces described first clamper component towards described second clamper component.

55. 1 kinds of bone fixation systems, including：

Implant, described implant includes can be against the first jig main body of the first surface positioning of bone, and can be against Described bone with described first surface back to second surface positioning the second jig main body；With

Apparatus, described apparatus includes the supporting member being configured to adjoin described second jig main body, and is configured to couple Actuator to described first jig main body so that slender member extends to the edge of described actuator from described first jig main body The described proximal direction position spaced a distance with described supporting member,

Wherein when described actuator is connected to described first jig main body, the flexible portion of described actuator is described along being perpendicular to The direction of proximal direction is spaced apart with described slender member so that when power is applied to described flexible portion, described actuator Described flexible portion deforms, in order to increase the distance between described position and described supporting member.

56. bone fixation systems according to claim 55, wherein apply described power towards described slender member and cause described Flexible portion deforms.

57. bone fixation systems according to claim 55, wherein said implant includes described slender member, wherein said Slender member is the connection element extending from described first jig main body.

58. bone fixation systems according to claim 56, wherein said connection element is configured to be attached to described actuating Device so that described connection element extends from the described position of described actuator.

59. bone fixation systems according to claim 56 or claim 57, wherein said connection element and described first Jig main body is integral.

60. bone fixation systems according to according to any one of claim 55 to 58, wherein said supporting member is configured to neighbour Connect the surface being limited by described second jig main body.

61. bone fixation systems according to according to any one of claim 55 to 58, wherein said second jig main body limits to be opened Mouthful, being sized to of described opening passes through the described connection element of reception.

62. bone fixation systems according to claim 55, wherein apparatus includes described slender member, and described elongated structure Part is from being positioned against the retainer that described supporting member extends described in described actuator, described retainer is configured to attachment To described first jig main body.

63. bone fixation systems according to claim 61, wherein said retainer is integral with described actuator.

64. bone fixation systems according to claim 62 or claim 63, wherein said second jig main body limits to be opened Mouthful, being sized to of described opening passes through the part receiving described retainer.

65. bone fixation systems according to according to any one of claim 62 to 64, wherein said first jig main body carrying the One guiding elements and the second guiding elements.

66. bone fixation systems according to claim 65, wherein said second jig main body includes that surface, the first guiding are main Body, the second guide main body being carried by described surface, described first guide main body and described second guide main body are configured to edge Described surface and guide described accordingly the first guiding elements and described second guiding elements.

67. bone fixation systems according to according to any one of claim 62 to 66, wherein said supporting member limits passage, institute State passage be sized to pass through the part receiving described retainer.

68. bone fixation systems according to according to any one of claim 55 to 67, wherein said actuator is configured to Changing between one configuration and actuated, in described first configuration, described position is in first relative to described supporting member Position, in described actuated, described position is in relative to supporting member and is spaced with primary importance along described proximal direction The second place opened, thus force described first jig main body towards described second jig main body.

69. bone fixation systems according to according to any one of claim 56 to 68, the described flexible part of wherein said actuator Point include the first actuating component and the second actuating component, described second actuating component along be perpendicular to the direction of described proximal direction with Described first actuating component is relative.

70. bone fixation systems according to according to any one of claim 55 to 69, wherein said first actuating component and described Second actuating component is corresponding elongated first axle and the second axis, wherein when described actuator is in described first configuration When, described first actuating component and described second actuating component each bend so that described first axle and described second axis There is curvature, and when described actuator is in described second actuated, described first actuating component and described second causes The dynamic deformation of member so that the described curvature of described first axle and described second axis reduces.

71. bone fixation systems according to according to any one of claim 55 to 70, wherein said first actuating component and described Second actuating component each includes at least one joint, and described first actuating component and described second actuating component can be Each joint bending at least one joint described, in order to cause described actuator to be deformed to from described first configuration described Second actuated.

72. 1 kinds of stretchers, including：

Supporting member, described supporting member includes the first side and second side relative with described first side, and described first lateral spacing is fixed Supporting surface；

Retainer, described retainer limits a part of opening being configured to receive implant, and wherein said retainer limits Inner surface, described inner surface at least partially defines described opening, and described inner surface is configured to be selectively engaged and departs from Engage the part being received of described implant；With

Actuator, described actuator be operable to so that described retainer relative to described supporting member along a first direction from One position move to from described primary importance displacement the second place, and make subsequently described retainer along with described first party Return to described primary importance to contrary second direction from the described second place,

The described inner surface of wherein said retainer is configured to when described retainer moves engage institute along described first direction State the part being received of implant, and be disengaged described implant when described retainer moves along described second direction The part being received.

73. 1 kinds of methods applying tension to element, said method comprising the steps of：

Supporting member is placed against the Part I of described element；

Insert the Part II of described element in the opening being limited by retainer；

Actuating power is applied to support the actuator of described retainer, thus causes the described holding partly limiting described opening The inner surface of device engages the described Part II of described element and the described Part II making described retainer and described element Move away from the described Part I of described element；

After described applying step, discharge described actuating power to cause described retainer relative to described the second of described element It is partially toward described supporting member to move；And

Repeat described applying step and described release steps.